JALT Meeting - Rolling Agenda and Minutes 2023

List of items to bring to JALT meeting

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wiki page	question	Last modified
wiki page	question	Last modified
Check pre acute consistent	JALT Julie found data discrepancies and asked if we could review doing cross checks at least on records with the same Visit Admit DtTm for the following fields: Pre acute living situation Province field Postal Code We reviewed a broader cross check proposal (link below) in some detail in a version available in the history of this page], so if we consider adding this we should confirm that none of those apply to any checks. Or we can ignore and just implement as soft-checks. Thoughts? Ttenbergen 12:28, 17 December 2025 (CST)	2025-12-17 6:30:28 PM
Chronic Health Facility	Discussed this at JALT Meeting - Rolling Agenda and Minutes 2025#JALT 2025-03-11 but I don't remember if we came to an answer or next step. Just found a note to add that we will also need to decide if any of these are in-patient locations. This would make them collectable as Pre-admit Inpatient Institution, and is relevant as per Pre-admit Inpatient Institution field#Data Use / Purpose. are you referring to PCH's because they are not inpt locations or are you referring to chronic health facilities? Lisa Kaita 14:52, 25 June 2025 (CDT)	2025-11-28 1:43:16 PM
Chronic Health Facility	This issue raised a problem with medicine data recently, and we will review again if this needs to be coded more granular after all, dicussed at JALT June 25, 2025: while Bojan would like this it is not possible to keep track of unit changes and not always easy to tell which unit they arrive from so leave a Riverview and Deer Lodge (DLC), with the exception of the PCH units in each facility.Lisa Kaita 14:52, 25 June 2025 (CDT)	2025-11-28 1:43:16 PM
Chronic Health Facility	We have discussed lately that we might want to become more nuanced about some chronic care locations (Deer Lodge (DLC) and Riverview). I have removed the details from the above linked fields and consolidated here. Once this page is cleaned up this discussion entry can be removed. Discussed at Task Team Meeting - Rolling Agenda and Minutes 2025#CHF4 Task Team Meeting - Rolling Agenda and Minutes 2025#CHF3 JALT Meeting - Rolling Agenda and Minutes 2025#CHF2 Task Team Meeting - Rolling Agenda and Minutes 2025#CHF1	2025-11-28 1:43:16 PM
Collection of data on homelessness	JALT Province - That definition doesn't make it clear to me whether the entry should be "NK Not Known / Not available" or "MB" - can we clarify that? Ttenbergen 00:17, 12 July 2025 (CDT) * who should we clarify with, I would think if they have a MB PHIN or are self pay then you would choose MB, if they don't then I would choose Not known Lisa Kaita 21:25, 6 September 2025 (CDT) more of a "tighten definition" than "check with"; from talking with SW this population frequently doesn't have their paperwork or registrations figured out, or their MB Health status has expired even if they would theoretically be covered, etc. This all came up when Julie checked for outliers and compared the province and postal code to determine status for homelessness.	2026-03-10 1:20:00 AM
Data Processor Portal	JALT We need a plan for how this gets done when Pagasa is away. Ttenbergen 12:29, 6 January 2026 (CST)	2026-01-06 6:31:16 PM
Definition of a Medicine Program Admission	JALT heard that some beds at STB may have been "given" to Nephro, so we may be collecting them? Made me do a quick query to get rough numbers, sent off to JALT. . Is there anything we want to update in our definition based on this?Ttenbergen 18:55, 8 December 2025 (CST)	2025-12-09 12:55:39 AM
Discharged to community	JALT Just a placeholder for now because the idea of how we define dispo to community (or for that matter, re-admit Previous Location) in data came up re. things like Readmission to MedWard and others. We have the obvious "Home" but if someone is discharged to something like Dialysis, would that also count? How do we define? Ideally by a column in s_dispo table such as s_dispo.loc_type, but that one uses "non-patient" which it also uses for Deceased patients (should we just split that out?). There is probably even more to this. Likely Julie has more than one approach in reporting. This came up because we were looking to define this for LAU collection readmission data. This is actually just as much regarding to admitted from community, so maybe this should just be renamed to "outpatient sites in s_dispo table"? This will need to be concistent with the concept of Pre-admit Inpatient Institution field ie they should not overlap, and possibly an entry's inclusion in that (ie s_dispo.inpatient unchecked) could be a way to define this.	2026-01-22 3:40:32 AM
Dispo field	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) Yes, I saw that, come to think of it I don't think we decided, not in my notes, but we can use it and I will change the wiki instructions Lisa Kaita 11:25, 13 March 2025 (CDT) If we are going to collect this detail for dispo, should we consider whether or not to also look at SH in preadmit living situation?, currently lumped with community facility with support. Lisa Kaita 14:45, 16 April 2025 (CDT) The entry name includes "TRSF" - is the entry for the previous location equivalent in EPR? Ttenbergen 23:30, 16 April 2025 (CDT) no because the previous location would usually be <site>_ER Lisa Kaita 09:53, 28 May 2025 (CDT) Sorry, I should have asked about "pre-hospital location in ADT". Ttenbergen 16:21, 28 May 2025 (CDT)	2026-03-11 7:10:29 AM
John or Jane Doe patient	JALT Entries for these would affect Overstay2 Overview and initial entry practice isn't currently clear in Minimal Data Set; is there anything we need to review with that in mind? Ttenbergen 13:47, 20 June 2025 (CDT) Most of our JD patients are identified at some point during their admission, I can't think of any that haven't been, are there many in the database? Lisa Kaita 21:29, 6 September 2025 (CDT) We use some of this data while incomplete, and it also has been a candidate for overstay parameters. Think of it coming from the "is this patient from Manitoba" vs "is this patient a JD". Even if they eventually become identified, that doesn't help with initial data. We are trying to define how this data should be handled in that scenario as well. Ttenbergen 10:13, 8 September 2025 (CDT) Julie had added some chart info for JD patients to the Postal code page, but its about chart so belongs here or in the chart page. So: do we want to consolidate the JD info here and link to field pages, or in field pages and link to this and use this just as an index? Or do we want templates for each so we can list the whole bit consistently on both? Ttenbergen 09:47, 11 August 2025 (CDT)	2026-03-10 1:35:07 AM
Patients residing in Manitoba with ambiguous MH Health coverage	JALT The page name isn't quite right, this concept is still evolving in documentation. Some of these may be better off broken out as their own pages or templates and only indexed from here.	2025-08-14 5:06:29 PM
Project NonTradLoc	JALT preliminary data review	2026-01-13 8:28:31 PM
Project Overstay2	We have had patients admitted from the chronic care unit at DLC (they live there) the nurses check off PCH for where they reside (on DPST), for Pre acute living situation field we enter Chronic Health Facility and for dispo we enter Deer Lodge, should we be considering this a PCH? as per instructions on DPST they do not continue the DPST form Lisa Kaita 12:35, 24 November 2025 (CST) Data definition for factor candidates for the Overstay2 project shows we are using PCH and Chronic Care as a group, they contribute equally to the score. The entry for Deer Lodge (DLC) in s_dispo table has s_dispo.loc_type "PCH", so entering Deer Lodge will also group this consistently. I am not sure that answers your question, though... should we consider it PCH for collection or data use purposes? If it is always clear when a patient comes from the Chronic Care part of DLC then maybe we should break this out? Ttenbergen 22:25, 26 November 2025 (CST) yes that answers my question, for the most part we can figure it out through the notes, lets leave collection as is. If you are ok with this lets take it off the JALT list Lisa Kaita 09:06, 17 December 2025 (CST) Agreed it doesn't need to be on JALT. I will keep it around as a comment because it's part of the whole Chronic Health Facility issue. Ttenbergen 11:44, 17 December 2025 (CST)	2025-12-17 5:44:01 PM
Query check tmp AHC	JALT if there is referral sent there must be a referral received entry and a consult dealt with entry Lisa Kaita 11:31, 7 August 2025 (CDT) pt could die in between? consult could go missing? In a way those would be really the ones we would want to know about, no? I suppose we could make it a soft check... Ttenbergen 16:26, 19 August 2025 (CDT) this almost sounds like the opposite of how I would have understood the current instructions. I would have thought those to mean to only enter "consult received" if there was no good data for consult sent. How do we actually want to use this? late answer: how did Julie analyze this? at the time all fields were mandatory, unless there was no consult, current status, collect consult sent and if no data found for this then use consult received. Lisa Kaita 12:59, 13 January 2026 (CST) I don't know, flagging for Julie and putting this on the JALT agenda; collection is still going, so we may still want to implement this. Ttenbergen 14:58, 13 January 2026 (CST)	2026-01-13 8:58:25 PM
Selkirk Mental Health Centre	JALT - Mental Health Facilities in Addition to Selkirk Should we add Eden Mental Health Centre as well? Are there others, like addiction treatment facilities (eg Bruce Oake), that we should code either as a group or individually? If we don't think this information is needed, should we also de-list our entry for Selkirk for consistency? Another option is to rename the selkirk entry and use it as an aggregate location going fwd.	2025-12-17 6:03:11 PM
Selkirk Mental Health Centre	JALT - Mental Health Facility Coding vs PCH currently aggregated as "PCH" because S dispo.loc type is PCH. That seems wrong. Should it be changed to “unknown/other” or to a new category “Mental Health”? And should we add Eden Mental Health Centre as well? Ttenbergen 16:21, 29 October 2025 (CDT) Julie reviewed, only 6 cases in our data (are we coding this consistently?). Julie emailed OK with “unknown/other”, but also raised how Pre acute living situation should be coded.	2025-12-17 6:03:11 PM
Service tmp post-send consistency checks	As discussed at JALT Meeting - Rolling Agenda and Minutes 2025#JALT 2025-11-27: Do we need any post-send, cross-record checks relating to Service tmp entry? Ttenbergen 16:44, 27 November 2025 (CST)	2025-11-27 10:44:27 PM
Service/Location field	2025-12-18 JALT - the notes about 2025-05 Revision of concept around ICUotherService / Intended1stSrvc also talked about Service/Location being made consistent with Boarding Loc; did we decide to proceed with this? The change to s_dispo table would be easy, but it would also apply to eg Previous Location, and any cross-checks or report using string literals to match would be affected, so testing the impact would be harder. Ttenbergen 02:42, 24 December 2025 (CST)	2025-12-24 8:46:05 AM
Standard data cleaning process	While discussing Visit Admit DtTm differences within same admission at JALT Meeting - Rolling Agenda and Minutes 2025#JALT 2025-03-11 I realized we don't have any part of your "cleaning" process documented. We should, even if it is a rudimentary notice of the SAS files you use and what you check for. Ttenbergen 21:51, 11 March 2025 (CDT) If there is linking beyond Populate linking pairs, or if you use a different linkage, we need to document that as well; do you? Ttenbergen 21:51, 11 March 2025 (CDT)	2025-03-12 2:51:43 AM
STB Medicine Collection Guide	There was a discussion about the beds that had been "handed to" them... what was the outcome, should it go here? still discussing at JALT AG will speak with nephro and NH about what to do going forward Lisa Kaita 10:43, 6 January 2026 (CST)	2026-01-06 4:43:51 PM
Transfer for bed management	JALT In Medicine records this will sometimes be related to Awaiting/delayed transfer to long-term care/PCH inside or outside of Winnipeg in the context of Paneling and Alternate Level of Care (ALC). Do we want to combine these as relevant? Do we anticipate wanting to report this data, and what do we need to consider to collect it to be able to do that? Ttenbergen 17:37, 27 November 2025 (CST)	2026-03-10 1:22:38 AM

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JALT Meeting – January 11, 2023

• Present: J,A,L,T
• Emails: LKaita@hsc.mb.ca; allan.garland@umanitoba.ca; JMojica@hsc.mb.ca; TTENBERGEN@hsc.mb.ca
• Minutes prepared by: AG
• Action items in BOLD

1. Followup about APACHE 2 Scoring. We now believe it is correct.

2. Visit_Admit_DtTm differences within same admission

• Tina reports that she has not received any such issues from Pagasa, and it's not clear if (a) there haven't been any vs. (b) there have been some but Pagasa has been dealing with them herself.
• Tina to ask Pagasa about this. If 'b' then we DO want them sent to Tina so she can send them to Charity to see if they can be fixed withing ADT/Cognos.
  • Tina emailed Pagasa Ttenbergen 11:22, 2022 December 8 (CST)

3. Regarding the new infrastructure to separately record both Dispo DtTm field (for when the patient is no longer under our care) and BedHeldEnd DtTm (for when the assigned bed is released).

• This only applies to situations when patient vacates the bed but it is "held" for expected or possible return of the patient.
  • The main such situations are the patient does NOT return after: (a) going elsewhere for a procedure, or (b) leaving AMA and the bed is held for a day or 2 hoping she/he will return. Which of these occurred is recorded in TEMP.
• Today we recognized another such situation: Patient living at St.Amont had a PEG, went back to St. Amont hoping he'd do well, but the hospital bed was held for a day just in case. As this situation isn't covered by recording AMA or Procedure in TEMP, we agreed to add another possible TEMP entry for such occurrence, to be named something like "Other" or "Weird Reason". Tina/Julie will implement this.
• Julie also inquired about how to now report about bed-days and occupancy. After discussion, we agreed that she will alter reporting as follows:
  • Primarily report on days patients were in beds being cared for in those beds (i.e. from Admit DtTm until Dispo DtTm.
  • But also report the ADDITIONAL cumulative days when beds were held with the expectation patients would return to them, but did not, as directly above.

4. Repeat item, regarding how to record time spent waiting for transfer (after Transfer Ready DtTm):

• We had previously decided to: (a) ignore such transfer delays <2 hrs, but (b) for all delays >=2 hrs to use the actual delay time.
• But this seems to conflict with the prior national Vital Signs Monitoring program (which is now defunct) which substracted 2 hrs from all actual delay intervals.
• Allan's rationale for not subtracting 2 hrs is as follows: While there are seemingly obligate delays in transferring a patient out (sending site getting the patient ready to travel and ensuring personnel are available, getting bed cleaned an ready in the accepting site and ensuring personnel are available) the concept of any given interval for these to occur is counter to the concept that we can and should always be striving to make out systems more efficient and reduce those delays.
• So, today Allan emailed Carmen, Rosanne and Bojan to get their input on this.

5. New question: How to deal with transfer delay in a recent case where patient in ICU was made ACP/C and then palliative ---> didn't die and indeed improved --> reversed the ACP/C and patient left ICU alive 7 days later.

• After discussion, we agreed that this is an extremely rare occurrence, and that rather than make a new rule for it, we will stick with the existing rule that transfer delays be calculated from when first transfer ready until the patient leaves. And also, this example is not fundamentally different from when a patient is ready to leave but gets sicker and the transfer is cancelled.

6. Julie identified that there are cases (esp at St. B ICUs) where ER is the first boarding loc but within a few minutes (or sometimes simultaneous with) that boarding loc, a 2nd boarding loc of ICU is recorded.

• We think this most likely is a phenomenon of incomplete charts and so at our next JALT meeting Julie will let us know if this still occurs (and the # of them) in complete charts. Also, Lisa will ask the ICU DCs at St. B about this.

7. Next JALT meeting January 12, 2023.