JALT Meeting - Rolling Agenda and Minutes 2023

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Revision as of 16:49, 25 January 2023 by Ttenbergen (talk | contribs) (JALT Meeting – January 11/12, 2023: option "weird reason" added to BedHeldEnd DtTm)
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List of items to bring to JALT meeting

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Chronic Health Facility 2025-10-29 8:43:36 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)
  • 2025-10-29 8:43:36 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
  • 2025-10-29 8:43:36 PM
    Dispo field JALT
  • does "Home with Support Services" include patients who are discharged home with private nursing service? (steph)
    • Good question. How is is used in EPR? We should probably stick with the EPR/HIS definition for consistency - do we know what that is for this? Julie also might have thoughts on how we would use this entry, will flag for her. Ttenbergen 01:02, 24 October 2025 (CDT)
  • 2025-10-30 7:50:07 PM
    Dispo field JALT
  • includes HSC Virtual Ward, as they are sent home and followed by a Physician and monitored
    • Is that how it is used in EPR or a decision we are making for our data? Ttenbergen 14:50, 30 October 2025 (CDT)
  • 2025-10-30 7:50:07 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)
    2025-10-30 7:50:07 PM
    Intended1stSrvc JALT
  • How do we want to do this, we could use the currently active entries for CC in s_dispo table:
  • HSC_IICU
  • HSC_MICU
  • HSC_SICU
  • STB_ACCU
  • STB_CICU
  • STB_MICU
  • or the full possible names under the CC services in S Cognos Services table that we actually use (in the last 2 months we had): Item

    • GH Critical Care / ACSS
    • GH Critical Care / General
    • GH Critical Care / General ICU
    • HSC Critical Care - MICU
    • HSC Critical Care / A Medicine
    • HSC Critical Care / A Non Teaching Med
    • HSC Critical Care / D Medicine
    • HSC Critical Care / D Non Teaching Med
    • HSC Critical Care / General
    • HSC Critical Care / H Medicine
    • HSC Critical Care / H Non Teaching Med
    • HSC Critical Care / Intermediate
    • HSC Critical Care / Medicine
    • HSC Critical Care / Neurosurgery
    • HSC Critical Care / Obstetrics
    • HSC Critical Care / Orthopedics
    • HSC Critical Care / Otolaryngology
    • HSC Critical Care / Plastics
    • HSC Critical Care / Respiratory
    • HSC Critical Care / Trauma
    • HSC Critical Care / Vascular
    • HSC Surgery / Neurosurgery
    • SBGH Cardiac / Cardiac Surgery
    • SBGH Cardiac / Crit Care Cardiology
    • SBGH Critical Care / Acute Care Surgery
    • SBGH Critical Care / B Service
    • SBGH Critical Care / C Service
    • SBGH Critical Care / Cardiac Surgery
    • SBGH Critical Care / Crit Care Cardiology
    • SBGH Critical Care / General
    • SBGH Critical Care / Medicine

    or we could use only the part before the "/" for the CC services in S Cognos Services table:

    • GH Critical Care
    • HSC Critical Care / Intermediate (this wouldn't be captured without the post-/ part)
    • HSC Critical Care
    • (but what would actually signify SICU, or would we again still need Service/Location for that?
    • SBGH Cardiac
    • SBGH Critical Care
    • SBGH Cardiac / Cardiac Surgery (this wouldn't be captured without the post-/ part)
    • SBGH Cardiac / Crit Care Cardiology (this wouldn't be captured without the post-/ part)
    2025-10-09 5:35:08 PM
    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
    Pre acute living situation field JALT should we be including Misericordia TCU here? Lisa Kaita 11:57, 5 June 2025 (CDT) 2025-11-04 8:39:09 PM
    Service/Location field
  • is this section still current? Ttenbergen 11:13, 6 March 2025 (CST)
  • It up for discussion tomorrow at JALT Meeting - Rolling Agenda and Minutes 2025 Lisa Kaita 21:04, 10 March 2025 (CDT)
  • Allan spoke with Bojan, to be discussed at next JALT Lisa Kaita 14:48, 16 April 2025 (CDT)
  • still being discussed at JALT Lisa Kaita 21:45, 9 September 2025 (CDT)
  • OK, discussion seems to be complete, we will change ICUotherService to Intended1stSrvc. I have cleaned up most peripheral links, but Lisa, could you make sure that this page reflects post-ICUotherService collection instructions? Any info about the change should really only be in 2025-05 Revision of concept around ICUotherService, which I have already linked from the legacy section of this page. We need to make sure that the info to make sense of the continuity of the data lives in that page. Ttenbergen
  • What will be the turn-over for this? New admissions starting Oct 1? Ttenbergen 14:54, 26 September 2025 (CDT)
  • 2025-09-26 7:54:49 PM
    Service/Location field
    • SMW


    • Cargo


    • Categories
    2025-09-26 7:54:49 PM
    Standard data cleaning process 2025-03-12 2:51:43 AM

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    JALT Meeting – January 11/12, 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. RESOLVED ITEM: 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 about this December 8, 2022 but hasn't heard back -- she'll followup with Pagasa

    3. RESOLVED ITEM: 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.Amant had a PEG, went back to St. Amant 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 has added this option to CCMDB as part of CCMDB.accdb Change Log 2023#2023-01-25.
    • 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. RESOLVED ITEM: 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.
    • Allan asked Bojan if this plan is OK, and he said yes.

    5. RESOLVED ITEM: 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. RESOLVED ITEM: 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.

    • Though we first thought this is a phenomenon of incomplete charts, Julie checked and it is NOT. After discussion we determined that this is a real phenomenon that occurs when ICU/ward team only agrees to accept the patient once a bed is available, and that once that happens the patient IS quickly transferred from ED to ICU or ward.

    7. In looking into #6, Julie noticed that there are 2 sorts of admissions about which she is concerned:

    • (1) Direct admit without passing through ED at all. These are real, and almost certainly are direct admissions from clinics to wards. So not a problem.
    • (2) Admit from ED triage without being put in an ED cot. Again, these may well be real, and if so likely are admissions to wards (rather than ICUs). Julie will send a few of these to Lisa, who will check on them.