Task Team Meeting - Rolling Agenda and Minutes 2025

From CCMDB Wiki
Jump to navigation Jump to search

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}}

Toggle columns: Last modified

wiki page question Last modified
wiki page question Last modified
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)
 2025-11-14 8:03:52 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?
    		•  2025-11-04 8:39:09 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
    Selkirk Mental Health Centre
  • 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)
    		•  2025-10-29 9:21:30 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)
    		•  2025-11-12 6:16:35 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)    		 2025-10-29 9:07:10 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)
    		 2025-10-08 1:25:23 AM
    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)
    		•  2025-10-24 2:28:08 PM

    Also see Task Team Meeting - Rolling Agenda and Minutes 2023

    _

    _

    ICU Database Task Group Meeting – February 27, 2025

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

    1. Template:ICD10 Guideline Pneumonia - Continued discussion about nosocomial bacterial superinfection of viral pneumonia

    • Julie showed us the numbers, pre and post the 14-day rule took effect, of acquired Pneumonia, bacterial codes. However, as these intervals were quite different, to interpret them we must have the denominators also. Julie will prepare that data for our next Task Group meeting.

    2. s_dispo table - Update about whether we should categorize locations (dispo, previous inpatient location, immediately pre-admit location) as general locations or as a specific location

    • Allan reported that Bojan indicated:
      • No need to identify specific LTC facilities
      • They do want to specify the different components of River View and Deer Lodge. Lisa will work on doing this, with Tina then to implement them.

    3. Template:ICD10 Guideline Decubitus Ulcer: Update regarding SICU's desire for more details about decubitus ulcers

    • Lisa was unsuccessful so far in contacting SICU nursing leadership about how they would want to handle multiple decubs in a given site, AND how long they would want such a temp project to last. She will continue to work on that.

    4. We had extensive discussion about whether or not to track (as ICD-10 diagnosis codes) specific electrolyte abnormalities.

    5. Past history of Covid-19 infection: Allan reported that after discussion with Bojan, we CAN STOP collecting past history of covid-19 infection (U07.5) Retired this code Lisa Kaita 15:53, 28 February 2025 (CST)

    6. Template:CCI Guideline Transfusions: New item: It was identified that different sites include/exclude transfusions in different locations, e.g. OR.

    • After discussion we agreed that going forward we will include ALL transfusions, done in any location, for a patient currently "assigned to ICU or ward". Updated the wiki Lisa Kaita 15:53, 28 February 2025 (CST)

    7. Next meeting march 27 at 11 am Central Time.

    ICU Database Task Group Meeting – January 29, 2025

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

    1. Continued discussion about nosocomial bacterial superinfection of viral pneumonia

    • Jen reported on her literature review:
      • It is not uncommon -- up to 20-40% depending in the virus
      • It commonly occurs <14 days after viral onset, often within 7-10 days
      • It is difficult to identify, and the diagnosis very likely has many false-positives
    • We generally agreed we should be able to track it, and that it would be a exception to the "14-day rule" for VAP. Possible ways to track it include:
    • Before making a final decision, Julie will try and estimate the number of them comparing 2023 with 2024 (before vs. after the 14-day rule took effect)

    2. Update about whether we should categorize locations (dispo, previous inpatient location, immediately pre-admit location) as general locations or as a specific location

    • Allan will followup with Bojan about this

    3. Update regarding SICU's desire for more details about decubitus ulcers

    • First, we agreed to add a new sub-code: L89.96 Decubitus (pressure) ulcer, pressure-induced deep tissue damage
    • Lisa clarified that SICU desires to subdivide decubs by site into 3: posterior, heel, others
      • Lisa will talk to SICU nursing leadership about how they would want to handle multiple decubs in a given site, AND how long they would want such a temp project to last

    4. New issue -- certain lab abnormalities, particularly Hypoalbuminemia, severe and Hyperphosphatemia, hypophosphotemia or other disorder of phosphate metabolism, severe or symptomatic are so common that perhaps we should modify their thresholds, or eliminate them

    • We agreed that prior to further discussion of this, Julie will identify the fraction of all patients (separately in ICU and wards) with those codes.

    5. Update on whether we can we stop collecting past history of covid-19 infection (U07.5) - Allan to email Bojan

    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 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 -- done

    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 (deep tissue injury) as a new stage (ICD-10 dx)

    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

    Retrieved from "https://ccmdb.kuality.ca/index.php?title=Task_Team_Meeting_-_Rolling_Agenda_and_Minutes_2025&oldid=162581"