Dispo field

Data Element (edit)
Field Name:	dispo
CCMDB Label:	Dispo
CCMDB tab:	Dispo
Table:	L Log table
Data type:	number
Length:	long
Program:	Med and CC
Created/Raw:	Raw
Start Date:	2016-07-01
End Date:	2300-01-01
Sort Index:	41

The Dispo field contains information about what happens to the patient at the end of their admission.

• SMW

Legacy implementation right in the table

• Cargo

• Categories

• Forms

Collection Instruction

surviving patients

• Enter:
  • for places where we collect, use the Service/Location used by the counterpart laptop: <site>_Med, GH-CC, HSC MICU , HSC SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU
  • for wards where we don't collect: <site>_Ward or other external entry e.g. home
• see Visits to temporary locations for dispo to temporary locations, ie. OR, dialysis, procedure suites of all types, imaging suites/radiology
• HSC Stepdown Units
• AMA see also BedHeldEnd DtTm

Homeless patients

• If a homeless patient is discharged, either to a place like Siloam Mission, shelter or even without a specific plan, then code them as discharged to home. Consider whether they might have left AMA.
• If discharged to an Alternative Integrated Accommodation with services use home with support services

Prison / Jail / Correctional Institution

If a patient is discharged to prison, jail or a correctional institution, code this as "TRSF to Correctional Facility" as dispo to be consistent with EPR

See Prison / Jail / Correctional Institution for additional coding instructions that may apply.

Additional options similar to "Home"

We have several "Home" like discharge options that may appear in Cognos2 Unit Starter. If the entry from ADT doesn't align with what is found in the chart then correct the entry to what you think is correct:

• Home with Support Services - Discharged to a private residence or apartment with support from the community at home or referred to services. example home care. Note a patient with instructions to return for follow-up or referral to a specialist (as part of a routine discharge order) is NOT considered discharge home with support service/referral
• TRSF Group/Supportive housing - use Dispo home or Home with Support Services if appropriate

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)

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• TRSF to Residential Care- Includes transfer to long-term care home (24 hour nursing), mental health and/or addiction treatment center or hospice/palliative care facility.
  • for PCH use Dispo PCH options
  • for hospice, see Hospice
  • for palliative care use the appropriate palliative care options
  • for mental health or addiction treatment center use Dispo Home with Support Services

Chronic Health Facility

This is somewhat messy and fluid, so see Chronic Health Facility

Discharged to ER or Urgent Care

If you discharge a patient to the ER or Urgent Care, you can't enter this in the dispo field. The reason is that this should not happen. If it really does happen:

• enter Not Canada or USA - unknown/other (this is a very rare entry so when we see it, we can question it. Put a note in to the Notes field so Pagasa can check there first.)
• email Pagasa so she can enter your ER / Urgent Care location as dispo.

We don't want ER to be available in the dropdown because it had been mistakenly entered a number of times. If it turns out there are a lot of legitimate discharges to ER we will make the option available.

Manitoba Nursing Station

• use "Outside City - unknown/other"

If this is actually done then why don't we just make the nursing stations available? We already have s_dispo table entries for them. 35 entries since 2016, 6 in the last 12 months. Are there other things for which this entry is used? Checked for reasons for this decision but they don't appear documented Ttenbergen 19:42, 13 March 2025 (CDT)

• SMW

• Cargo

• Categories

Deceased patients

See

• Deceased patients#General instructions for deceased patients
• Guideline for coding organ donation after death
• Visits to temporary locations

"Can we remove the items that are no longer Service/Locations, Previous Locations, Pre-admit Inpatient Institutions or dispo locations from the dropdowns?"

We can and will remove them, but that can only happen once no more laptops use them. We will need to keep track of this and then remove them when ready. If I removed them now, then any box that currently has them enter would misbehave.

ExpandSQL query of what is currently available

SELECT s_dispo.location_name, s_dispo.Site, s_dispo.active, s_dispo.inpatient, s_dispo.previous_location, s_dispo.s_location, s_dispo.dispo FROM s_dispo WHERE (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.inpatient)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.previous_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.s_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.dispo)=True));

• query of what is currently used: query z_s_dispo_inactivatable

Data Use / Indicators

• Unit Mortality
• ICU Interfacility Transfer/Length of Time for Transfer from ED to ICU within same facility/Transfer Delay (Critical Care)/Transfer Delay (Medicine)
• Discharges out of hospital
• Organ donor rate
• AMA Rate
• Linking admissions
• Readmission Rate to ICU/Readmission to MedWard

Data Integrity Checks (automatic list)

	App	Status
Check pre acute consistent	CCMDB.accdb	declined
Function Validate Dispo	CCMDB.accdb	implemented
Check function location NE dispo	CCMDB.accdb	implemented
Query check ICD10 dx implying death must have appropriate dispo	CCMDB.accdb	implemented
Query check dispo lower acuity than location	CCMDB.accdb	retired
Link suspect dead then alive query	Centralized data front end.accdb	implemented
Link suspect mismatch to ours incomplete query	Centralized data front end.accdb	implemented
Link_suspect_not_same_visitAdmitDtTm query	Centralized data front end.accdb	implemented
Query cardiac arrest throughout admission	Centralized data front end.accdb	needs review
Link_suspect_visitAdmitDtTm_mult_to-from-home query	Centralized data front end.accdb	ready to implement

Implementation

The field is populated with options from the s dispo table.

Legacy

• 2025-03-11
  • one other option in EPR for discharge to was "TRSF to Residential Care" - we decided not to switch to this because we currently record more detailed information.

That more detailed info included things like HSC Lennox Bell; we discussed whether or not we need to document the details of this. If so, the following is likely a starting point: Home Home with support Institution NOS TRSF Group/Supportive housing TRSF to Correctional Facility any Hospices GH-Transitional care HSC - Transitional care Misericordia - Transitional care STB - Transitional care VIC - Transitional care HSC Lennox Bell Manitoba Adolescent Treatment Center - unknown/other

• SMW

• Cargo

• Categories

• 2025-03-07
  • started to collect "TRSF to Correctional Facility" as dispo to be consistent with EPR; for Previous Location continue to use the old entry "Institution, NOS"

earlier legacy info

This field is part of the 2016 Time and Place changes and was affected by the PatientFollow_Project.

It a combination of our previous

• Discharge To
• Var 2 - Discharge-to Ward
• ICU Var 6 - AMA
• Survive / Expired

Data from these fields has been back-populated to the this field so data is available from the beginning of the database.

Related articles:

• Organ Donor/Braindead

Very early missing Discharge-tos

There were 6762 very old ICU records who are listed as survived but didn’t have a discharge-to. This is from HSC-only days when there simply were no checks.

When data was brought across from the old discharge to field the dispo fields of these records were set to 'survive(Legacy)'.