Task Team Meeting - Rolling Agenda and Minutes 2023

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List of items to bring to task meeting

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Chronic Health Facility 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
Decubitus (pressure) ulcer, stage not indicated, of heel
  • This instruction is taken from old dx Decubitus (pressure) ulcer, stage not indicated; since we will now have a series of codes for suspected deep tissue injury, we need to change this, but what should be here, and what should move into Template:Decubitus Deep Tissue Damage Details? Ttenbergen 15:29, 30 June 2025 (CDT)
    • This page should remain the same, deep tissue injury is really considered to be a different way to stage/document decubitus ulcers An unstageable ulcer is still used in documentation and grading of decubitus ulcers Lisa Kaita 20:23, 7 October 2025 (CDT)
      • This template had an evil twin "Template:Decubitus Stage not indicated Details" that wasn't actually linked, I cleaned it up and moved this question from that template to here. This template is linked from all unstageable decube pages. I am concerned that the instructions that were brought over might mislead someone to coding a deep tissue injury as "stage not indicated". Possibly all it takes is to remove that, just want to make sure it doesn't need to be replaced with something else. Ttenbergen 01:46, 11 March 2026 (CDT)
    		•  2025-10-23 7:56:14 PM
    Decubitus (pressure) ulcer, stage not indicated, of other area
  • This instruction is taken from old dx Decubitus (pressure) ulcer, stage not indicated; since we will now have a series of codes for suspected deep tissue injury, we need to change this, but what should be here, and what should move into Template:Decubitus Deep Tissue Damage Details? Ttenbergen 15:29, 30 June 2025 (CDT)
    • This page should remain the same, deep tissue injury is really considered to be a different way to stage/document decubitus ulcers An unstageable ulcer is still used in documentation and grading of decubitus ulcers Lisa Kaita 20:23, 7 October 2025 (CDT)
      • This template had an evil twin "Template:Decubitus Stage not indicated Details" that wasn't actually linked, I cleaned it up and moved this question from that template to here. This template is linked from all unstageable decube pages. I am concerned that the instructions that were brought over might mislead someone to coding a deep tissue injury as "stage not indicated". Possibly all it takes is to remove that, just want to make sure it doesn't need to be replaced with something else. Ttenbergen 01:46, 11 March 2026 (CDT)
    		•  2025-10-23 7:56:19 PM
    Decubitus (pressure) ulcer, stage not indicated, of sacral area
  • This instruction is taken from old dx Decubitus (pressure) ulcer, stage not indicated; since we will now have a series of codes for suspected deep tissue injury, we need to change this, but what should be here, and what should move into Template:Decubitus Deep Tissue Damage Details? Ttenbergen 15:29, 30 June 2025 (CDT)
    • This page should remain the same, deep tissue injury is really considered to be a different way to stage/document decubitus ulcers An unstageable ulcer is still used in documentation and grading of decubitus ulcers Lisa Kaita 20:23, 7 October 2025 (CDT)
      • This template had an evil twin "Template:Decubitus Stage not indicated Details" that wasn't actually linked, I cleaned it up and moved this question from that template to here. This template is linked from all unstageable decube pages. I am concerned that the instructions that were brought over might mislead someone to coding a deep tissue injury as "stage not indicated". Possibly all it takes is to remove that, just want to make sure it doesn't need to be replaced with something else. Ttenbergen 01:46, 11 March 2026 (CDT)
    		•  2025-10-23 7:56:12 PM
    Diabetes mellitus chronic complication: Nephropathy I have a patient that has had a pancreas transplant and this has cured his diabetes. He still has retinopathy, neuropathy, etc. Can I code all of the complications of diabetees without linking them to Diabetes mellitus type 1, with chronic complication (code complications separately)"Mlagadi 09:17, 4 February 2026 (CST)
  • The program should let you do it - I added the tag that would flag cross checks for this diagnosis to the bottom of this wiki page and it finds nothing. I'll leave for Task to answer whether that is how we want to code it. Ttenbergen 09:59, 4 February 2026 (CST)
    		•  2026-02-04 3:59:30 PM
    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)
    		•  2026-03-14 1:38:21 AM
    Plasmapheresis should we also use this code for Leukapheresis, or is leukapheresis something that we should not bother coding? I have only come across leukapheresis once, so I am assuming that it is a rare treatment... 2026-03-10 2:51:23 PM
    Pre acute living situation field
  • We found some cases where, during the same hospitalization, there are different values for this. For example, the first ward admission may have "house" and the immediate next ICU admission may have "PCH". I think there is no scenario where that makes sense. If you can think of one, tell me.
  • For existing data like this, how would we best treat it heuristically. Would the first record be more likely to be right because the chart is still cleaner and easier to follow? Or would a later record be more likely to be correct since more of the patient's story would have emerged? Thoughts?
  • This may arise when we complete the profiles separately ie. medicine done before ICU or vice versa, and more information may be more available in the chart, or it may have been an error where one was updated the other was not Lisa Kaita 15:32, 26 November 2025 (CST)
    		•  2025-12-17 6:07:30 PM
    Publications, abstracts, presentations using the Critical Care and Medicine Database
  • This page is an indicator of how we fulfill the research component of the CCMDB#Purpose and Mission. To keep it useful and representative of current work, entries need to be added on an ongoing basis as new outputs occur. To make this reliable, how do we build this into our workflow (e.g., as part of the Database Request Process), so the record stays current with minimal overhead? At present this relies on post-hoc updates from requestors, which has had limited uptake.
    		•  2025-12-31 8:13:08 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.
    • There are also "Brandon Centre for Adult Psychiatry (CAP)" and "Parkland Regional Mental Health Centre" (PMH link); likely other RHAs have similar. Ttenbergen 22:16, 15 March 2026 (CDT)
    		•  2026-03-16 3:16:25 AM
    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.
    		•  2026-03-16 3:16:25 AM
    Sex field
  • I just came across an incomplete record (from S9 laptop) that has a sex entry "Undiff". Our dropdown doesn't contain this so this likely came from Cognos. If this is now being coded in EPR, and considering that this would affect the "biological sex" we use in defining this, should we introduce this as an option? If we do not want to introduce this as an option, do our cross checks catch this? They might not, since this could not have been entered manually. Ttenbergen 00:16, 12 November 2025 (CST)
  • the chart was read and the above guideline was followed, can we remove this question? Lisa Kaita 11:25, 4 March 2026 (CST)
    • The instructions above actually don't address Intersex individuals whose physical or chromosomal situation is not clear. We could change the instructions to "assigned at birth" and remove any reference to "biological", which would mean we collect something other than their biological status. The current instructions don't address all possibilities. Ttenbergen 00:17, 11 March 2026 (CDT)
    		•  2026-03-11 5:17:34 AM
    St.Amant Since 2022:

    Pre acute living situation for patients where Dispo is St Amant has been recorded as:

    • 23 Chronic Health Facility
    • 14 Community Facility with support
    • 5 Personal Care Home
    • 2 House
    • 1 other - known but not listed
    • 1 Apartment

    Pre acute living situation for patients where Previous Location is St Amant has been recorded as:

    • 1 Apartment
    • 1 Personal Care Home

    How are we using this code, and how should we use it? Ttenbergen 16:07, 29 October 2025 (CDT)

    * When I have seen this in a chart the address is usually 440 River Road, which is the St Amant facility, I code it as per the wiki instructions, as a chronic care facility. I know that St Amant has several group homes as well, but I wouldn't know their addresses and the documentation is usually not that specific to include who manages the group home. With the new dispo options, group homes would be transfer to group/supportive housing Lisa Kaita 15:46, 26 November 2025 (CST)    		 2025-11-26 9:46:22 PM
    Template:CCI Guideline Transfusions can we please reconsider if we should count all plasma given during plasmapheresis? We only count the first time plex is done, so is it relevant how many are given during plasma? Lisa Kaita 08:17, 24 March 2026 (CDT) 2026-03-24 1:17:07 PM
    Template:Decubitus Stage Not Indicated Details
    • This instruction is taken from old dx Decubitus (pressure) ulcer, stage not indicated; since we will now have a series of codes for suspected deep tissue injury, we need to change this, but what should be here, and what should move into Template:Decubitus Deep Tissue Damage Details? Ttenbergen 15:29, 30 June 2025 (CDT)
      • This page should remain the same, deep tissue injury is really considered to be a different way to stage/document decubitus ulcers An unstageable ulcer is still used in documentation and grading of decubitus ulcers Lisa Kaita 20:23, 7 October 2025 (CDT)
        • This template had an evil twin "Template:Decubitus Stage not indicated Details" that wasn't actually linked, I cleaned it up and moved this question from that template to here. This template is linked from all unstageable decube pages. I am concerned that the instructions that were brought over might mislead someone to coding a deep tissue injury as "stage not indicated". Possibly all it takes is to remove that, just want to make sure it doesn't need to be replaced with something else. Ttenbergen 01:46, 11 March 2026 (CDT)
    		 2026-03-11 6:46:51 AM
    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
    Transfusion of platelets can we please reconsider if we should count all plasma given during plasmapheresis? We only count the first time plex is done, so is it relevant how many are given during plasma? Lisa Kaita 08:17, 24 March 2026 (CDT) 2020-12-16 7:51:30 PM
    Transfusion of PRBC can we please reconsider if we should count all plasma given during plasmapheresis? We only count the first time plex is done, so is it relevant how many are given during plasma? Lisa Kaita 08:17, 24 March 2026 (CDT) 2023-02-24 4:43:09 PM
    Transfusion of WBC can we please reconsider if we should count all plasma given during plasmapheresis? We only count the first time plex is done, so is it relevant how many are given during plasma? Lisa Kaita 08:17, 24 March 2026 (CDT) 2020-12-16 7:51:14 PM

    Also see Task Team Meeting - Rolling Agenda and Minutes 2022

    _

    _

    ICU Database Task Group Meeting – Jan 11, 2023

    • Present: Allan, Gail, Julie, Michelle, Mindy, Stephanie, Tina, Val, Pagasa, Mailah
    • Minutes prepared by: AG
    • Action items in BOLD

    1. Transition to Database Server#Shared Health - Nothing new about either of the possible alternative options for hosting the database.

    2. Controlling Dx Type for ICD10 codes - Regarding the task to improve data collector diagnosis assignment into the 3 "bins" of admission diagnosis, acquired diagnosis and comorbid diagnosis.

    • Lisa indicated that for a first pass on this, she will distribute all the codes among all the collectors.

    3. New item: Clarification of Pulmonary emphysema or bullous disease without COPD. Allan modified this Wiki entry to make it clearer.

    4. New item: Regarding the code Sudden cardiac death (and died)

    • After discussion we recognized that we have no need to specifically code patients' cause of death. We know it occurred by virtue of the Dispo field. Thus we agreed to remove this item from the list of ICD-10 codes, and to have Julie go into all records where it has been recorded and remove it. Allan modified the Wiki page also.

    5. New question: It was noticed that an error occurs if a diagnosis of Influenza is recorded (which is an implied bug) and one attempts to combine it with a Nosocomial problem code.

    6. Followup item from long ago: Seeking to get ABGs at Grace Hospital to be included in the Lab Info System (LIS).

    • The last time we tried for this, in 2015, the resp therapy group at Grace was not interested in being required to manually logging this information into LIS, as IS done at HSC and St. B.
    • We think they may be more open to it now -- so today Allan emailed Heather Smith, asking her to raise it with them.
    • If they indeed are willing, Allan will talk to Dr. Soroko about getting it implemented.

    7. New item: Uncertainty of when/how to use Complication of labor and delivery, NOS

    • As our database is only for adult patients, this code should not be used to indicate such a complication for a newborn. For example: During hospitalization, such a complication occurs, but it only affects the newborn and has no medical consequence for the mother --- do NOT use this code.
    • Of course, for some such complications when the newborn with a complication becomes an adult, that problem persists, e.g. Fetal Alcohol Syndrome. If that adult is then admitted, it is the specific problem (such as Fetal Alcohol Syndrome) that should be listed as a Comorbid Diagnoses -- again you would NOT code Complication of labor and delivery, NOS.
    • The only time Complication of labor and delivery, NOS would be coded is when the mother herself incurs a complication of labor or delivery, AND there is not a more specific code for the complication she suffered.
    • Allan modified this Wiki page for clarity.

    8. New item: Clarification of when/how to use Oral mucositis

    • This code is for widespread or diffuse oral mucus membrane involvement -- as often occurs after some chemotherapies, and a few other causes.
    • Do not use it for localized oral lesions or involvement in just a part of the oral mucosa. In such a case code the specific cause if known, and otherwise use Disorder of oral mucosa (mouth, lips, tongue), NOS.
    • Allan has updated the Wiki to reflect this.

    2022...

    Also see Task Team Meeting - Rolling Agenda and Minutes 2022

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