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Task Team Meeting - Rolling Agenda and Minutes 2025

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List of items to bring to task meeting

Add to this by adding the following to the article where the problem is documented: 

{{DiscussTask | explanation}}

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APACHE physiological variable collection If a patient goes to the OR in the first 24 hours of admission, do we use OR VS in our Apache variables? Lisa Kaita 09:18, 21 April 2026 (CDT) 2026-04-21 2:18:29 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
    Glasgow Coma Scale Can we please revisit this and expand our examples, for example, patient arrives in ER with a GCS of 15, arrests and is then sedated to A RASS -5 for days or dies within 24 hours of admission. Should we be putting the APACHE GCS as Aler and intubated appears oriented? or assume the worst GCS of 3? Lisa Kaita 12:06, 20 April 2026 (CDT) 2026-04-20 5:06:42 PM
    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... 2026-04-21 2:43:20 PM
    Pre acute living situation field JALT
  • 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)
    		•  2026-04-26 12:31:03 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)
    		•  2026-04-14 4:56:36 PM
    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 2023

    _

    _

    Last year's last meeting, included for continuity

    ICU Database Task Group Meeting – December 4, 2024

    • Present: Allan, Lisa, Julie, Jen, Mindy, Pagasa, Hardeep, Allyson, Val, Gail, Mailah, Dan, Tina
    • Minutes prepared by: AG
    • Action items in BOLD

    1. Dan explained a modification/expansion of the ward Overstay project

    • Currently we have a "transfer ready" date flag(Transfer Ready DtTm tmp entry) -- which indicates when not only the medical team, but all involved ancillary services deem the patient cleared to leave the hospital
    • We are adding a new "medically ready" flag (Project MR) -- which indicates when the ward medical team considers the patient able to leave hospital. Dan explained that he is working with the sites and the ward physicians to ensure that they identify this timepoint in the notes and/or orders.
    • Also, we have begun collecting the existence of ancillary health consults on wards (Project AHC)

    2. Update on Pneumonia, ventilator-associated (VAP)‎‎ coding

    • Lisa related that at the recent meeting of all data collectors, Jen presented the current VAP coding criteria, including the CDC 14-day blackout period for identifying subsequent pneumonias of any type
    • After discussion, we agreed continue to consider ECMO patients for VAPs -- this is relevant because CDC guidelines exclude that patient population.
    • The question arose about whether that 14 day rule should apply to bacterial superinfection of an initial viral pneumonia:
      • There is rationale for both doing and not doing this.
      • Before we make a final determination, Jen will perform a literature search about the frequency of such an event.
    • As the items contained in the "Recent Previous Pneumonia" segment of what is now on the VAP page (mainly the 14 day blackout rule) is relevant to all pneumonias, Tina will convert that to a template to be included in all the pneumonia Wiki pages
    • Jen will add some clarifying material to the 2nd primary bullet of the "Recent Previous Pneumonia" segment

    3. Should we categorize locations (dispo, previous locations, pre-admit) as general locations or as a specific location?

    4. Add decubitus ulcer locations, request from SICU manager, Andie did a study evaluating the use of a new mepilex protective dressing. Her findings are as follows:

    • 6 months pre-trial n=27 with 12 non-coccyx ulcers
    Total sacral/coccyx/buttock injuries- 15 
Stage 1	1
Stage 2	13
Stage 3	0
Stage 4	0
DTI	1

    During/post 6 months (just missing November data at this time). n=13 with 10 or possible 7 non-coccyx ulcers 

    Total sacral/coccyx/buttock injuries- 3 confirmed (however, 3 charts not reviewed yet…so could be up to 6)
Stage 1	 
Stage 2	 
Stage 3	1
Stage 4	 
DTI	1
Unstagable	1
      • Knowing the location long term will help us to track long term how we are doing without having to review every chart. While overall pressure injuries are good to know anecdotally, it doesn’t really give the big picture of if we are making an impact on the care. Especially since you are looking at the location anyways, does it hurt to record the area? Even a range of areas?
      • Our only tool currently to know locations etc is RL6 and we are quite certain that wounds are extremely underreported in RL.. I have not compared the data from the last year in RL vs these charts but I presume it will reflect this.
      • We also need to add DTI as a new stage

    5. Can we stop collecting past history of covid-19 infection (U07.5)? - Allan to email Bojan

    6. Next meeting January 29 at 10 am CST


    2024...

    Also see Task Team Meeting - Rolling Agenda and Minutes 2024

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