JALT Meeting - Rolling Agenda and Minutes 2023

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List of items to bring to JALT meeting

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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:
  • 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
  • 2025-11-28 1:43:16 PM
    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"?
    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)
    2026-01-27 5:10:08 PM
    Intended1stSrvc JALT
  • 2025-12-18 JALT - We may want to discuss the discrepancy of our naming and its implications with the recipients of our reports and possibly the team that reports similar out of EPR. Ttenbergen 14:44, 23 December 2025 (CST)
  • 2026-01-29 4:54:48 PM
    Intended1stSrvc JALT
  • Can these entries only be at the same site as the record (eg would "Gra ICU" be a legit entry for a patient at HSC MICU)? If only same siet that may be a relevant cross-check.
  • 2026-01-29 4:54:48 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
    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)
  • 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
    Sending Patients JALT
  • Can we again revisit the pros and cons of sending only when working on site against sending from home? There is always a need of updated data and I do not want to be emailing everyone to send when data are needed. This can be solved by sending in all days the collector works regardless onsite or from home during the assigned time slots. In addition, I think this practice of submitting data frequently will also mean lesser new data on the laptop if unfortunate incident happens on the laptop and there is a need to re-enter data again. Do we still experience problem in sending when we set up the sending time schedule by site? --JMojica 16:37, 2 December 2025 (CST)
  • There might be ways to make sending faster or more reliable. This would take a fair bit of analysis and testing.
    One reason I have not pursued this is the prospect of re-platforming. A cloud based system would eliminate sending; it might cause new process tangles but that's a different topic. So it would be good to have an idea of the time horizon for this to decide if the work to mitigate the errors and reduce sending restrictions is worth it.
    It might be possible to find a compromise that re-balances risk and benefit. Ttenbergen 01:19, 3 December 2025 (CST)
    • I heard nothing from the collectors about errors in sending since we started this new schedule. If they work from home, can we allow them to send? They can send early or after 04:30 PM. PTorres 14:27, 3 December 2025 (CST)
      • Open to it. If things work fine now, changing process may break them again. Ttenbergen 11:50, 17 December 2025 (CST)
    2025-12-17 5:50:08 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

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    JALT Meeting – March 22, 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. Update regarding those records where ER is the first boarding loc but the patient is there for only a few minutes, or even for Zero minutes.

    • Per last time, we recognized that these are real when the patient is actually in an ER bed.
    • What we don't yet know is about the cases (of which Julie found 147) where patient is admitted from ED triage without being put in an ED cot.
    • The crux of this issue is exactly how our users utilize this information. If, as we suspect, it is to identify opportunities for substantially reducing such ER delays, then short delays (e.g. <10 mins for sure, and prob even <20 mins) are irrelevant as they're not likely remediable. If this is the case, then for collection and reporting purposes we should only report on those with ER delays >some threshold (e.g. 30 mins).
    • Allan emailed Bojan, Carmen and Roseanne about this today ---> and they replied that indeed they only care about delays that are substantial.
    JALT
    
    • For CC Reports, ER Delay for LE 30 minutes, ignore (treat as zero) and GT 30 minutes, use actual ER Delay. N is number of cases where previous location is from own ER, CC reports Mean ER Delay as Total ER delays/N and Median ER based on N. Prior to Oct 2020, we calculate ER delay as Arrive Dttm - Accept Dttm. But there are cases where Accept Dttm is missing, therefore ER Delay is missing and these missing are not included in N. Are all these correct? --JMojica 17:36, 2023 February 13 (CST)
    • For Medicine Reports, I am reporting LOS (mean, std, total, min, max) per Boarding LOC which includes ER . Should the GT 30 mins threshold be applied for ER boarding loc or use actual ER LOS? do we need to follow the same rule for both CC and Med? --JMojica 17:36, 2023 February 13 (CST)
    • SMW


    • Cargo


    • Categories

    2. We need to update out yearly PIA report. Tina will email the last one to Allan.

    3. Discussion about the intention throughout the province to start collecting (voluntarily) on indiginous status and LGBTQ status. We recognized that this would be very interesting data to have in our databases.

    • Allan related that "they" are working on a governance plan, so Tina will put a reminder on this item to revisit it December 2023.

    4. Information suggests that the Dept of Medicine is (again) contemplating ceasing to fund the Medicine database.

    • Allan spoke today with Bojan about this, particularly about the importance of ensuring that IF they do so, that the ICU Database will be protected. The plan is that Allan and Bojan will meet with Dr. Renner and Hana to discuss these issues.

    5. Question about whether to include medicine patients on a soon-to-open ward at HSC, that might be a mixed (medicine and non-medicine patients) ward.

    • Answer: Yes, but only include those on Medicine service.

    6. We were informed that Hi Obs at HSC has recently had some patients on non-Medicine services (Respirology, Neurology). We agreed that we will only include the Medicine patients in our database.

    7. Update on Charlson comorbidity coding. Allan to respond to the email sent by Tina on Jan 26, 2023.


    JALT Meeting – Feb 2, 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. Update regarding those records where ER is the first boarding loc but the patient is there for only a few minutes, or even for Zero minutes.

    • Per last time, we recognized that these are real when the patient is actually in an ER bed.
    • What we don't yet know is about the cases (of which Julie found 147) where patient is admitted from ED triage without being put in an ED cot.
    • The crux of this issue is exactly how our users utilize this information. If, as we suspect, it is to identify opportunities for substantially reducing such ER delays, then short delays (e.g. <10 mins for sure, and prob even <20 mins) are irrelevant as they're not likely remediable. If this is the case, then for collection and reporting purposes we should only report on those with ER delays >some threshold (e.g. 30 mins).
    • Allan emailed Bojan, Carmen and Roseanne about this today ---> and they replied that indeed they only care about delays that are substantial.
    JALT
    
    • For CC Reports, ER Delay for LE 30 minutes, ignore (treat as zero) and GT 30 minutes, use actual ER Delay. N is number of cases where previous location is from own ER, CC reports Mean ER Delay as Total ER delays/N and Median ER based on N. Prior to Oct 2020, we calculate ER delay as Arrive Dttm - Accept Dttm. But there are cases where Accept Dttm is missing, therefore ER Delay is missing and these missing are not included in N. Are all these correct? --JMojica 17:36, 2023 February 13 (CST)
    • For Medicine Reports, I am reporting LOS (mean, std, total, min, max) per Boarding LOC which includes ER . Should the GT 30 mins threshold be applied for ER boarding loc or use actual ER LOS? do we need to follow the same rule for both CC and Med? --JMojica 17:36, 2023 February 13 (CST)
    • SMW


    • Cargo


    • Categories

    2. We need to update out yearly PIA report. Tina will email the last one to Allan.

    3. Discussion about the intention throughout the province to start collecting (voluntarily) on indiginous status and LGBTQ status. We recognized that this would be very interesting data to have in our databases.

    • Allan related that "they" are working on a governance plan, so Tina will put a reminder on this item to revisit it December 2023.

    4. Information suggests that the Dept of Medicine is (again) contemplating ceasing to fund the Medicine database.

    • Allan spoke today with Bojan about this, particularly about the importance of ensuring that IF they do so, that the ICU Database will be protected. The plan is that Allan and Bojan will meet with Dr. Renner and Hana to discuss these issues.

    5. Question about whether to include medicine patients on a soon-to-open ward at HSC, that might be a mixed (medicine and non-medicine patients) ward.

    • Answer: Yes, but only include those on Medicine service.

    6. We were informed that Hi Obs at HSC has recently had some patients on non-Medicine services (Respirology, Neurology). We agreed that we will only include the Medicine patients in our database.

    7. Update on Charlson comorbidity coding. Allan to respond to the email sent by Tina on Jan 26, 2023.

    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 Chastity to see if they can be fixed withing ADT/Cognos.
      • Tina emailed Pagasa about this December 8, 2022 but hasn't heard back, and again 2023-01-25.

    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.

    Previous

    For earlier minutes see JALT Meeting - Rolling Agenda and Minutes 2022