Requested CCMDB changes for the next version

see the Development Documentation Category for other development logs

Post-Roll-out Cleanup for DB update

• Make sure that data mdb is no longer being rolled out in update batch file.

Bug Fixes

Out of Memory

• Occasional Out of Memory Error when adding patients (both Pat and Deb reported this). Ttenbergen 18:18, 1 December 2010 (CST)

Functional Improvements

Early ID Study

add Early_ID_study#Consistency_Checks once questions are answered. Ttenbergen 13:29, 24 December 2010 (CST)

Apache secondary upper and lower limit verifying abnormal Apache values by collectors using Access

Apache limits - upper and lower - set secondary limits for some of the values for Apache or MOST - these are values that can be occur, but are not the norm. Julie to review database and advise what the values will be. Purpose, reduce checks and question to collectors--TOstryzniuk 18:48, 5 November 2010 (CDT)

Implement mean BP calculation tool on laptop

It would be beneficial to put in a mean BP helper (like the ABG helper) so that we could enter our systolic and diastolic BP's and it would automatically calculate the mean BP and perhaps even indicate the higher apache score and then we could pick the worst one. This would make apache scores more accurate.

Changing the local data structure automatically

• update or separate article when the BP helper using L_BPs is implemented
• add s_FinalChecks, fix all spots that use FinalCheck (or make a function to check it)
• update when done: CCMDB.mdb; "News and backup" batch file; Settings.mdb

Changes Under Discussion

These requested changes can not be processed until the questions about them have been answered. Wherever possible the discussion should conclude in the home article of the topic. If a topic has no home article, it can be listed here.

Full Apache Score

Add full apache score to the Viewer form

• That one would need thorough testing to make sure I got the score right, e.g. enter 10 patients and check if their apache scores in ccmdb are what you would have calculated. Any volunteers for the testing? If it won't be validated I'd rather not add this to confuse anyone. Ttenbergen 11:05, 9 June 2010 (CDT)
  • Marie Laporte offered to help with this. I will let her know once I have implemented this. Ttenbergen 16:01, 2 July 2010 (CDT)

• What would this "full apache score" be used for? Much of the diagnostic scoring seems to be documented only in the form of a macro which will be a mess to decipher and implement in Access. What is the benefit? Ttenbergen 10:48, 29 October 2010 (CDT)

Help to manage Serial numbers

If I understand right data collectors currently collect one or more locations from one or more pools of serial number pools. Details of the serial number system are located in Serial number. This has been flagged as one reason why people find paper printouts of the most recent patients sent useful.

Serial numbers have to be unique for a collection location, so if a ward like HSC_H4H is collected on by multiple collectors then a serial number must never be re-used. One way this is achieved is to assign blocks of numbers for each 100 possible serial numbers to a given collector.

A study number must be entered before any other data since access uses it to set the relationships for the data. To accomplish that, function new_pat_id() opens a window requesting the serial number pops up when "add new patient" is clicked on the patient list.

Added question to Serial_number#Special-Use_Serial_Numbers to find out if any serial numbers need to be "reserved".

Possible Solution

The program would provide a default serial number. For locations with only one serial pool, this would be a one-step, transparent process. Collectors with more than one serial number pools would get a dropdown list of possible pools; upon choosing one the program would default to serial (most recent+1). Collectors using only blocks of serial numbers would have to keep track if they are "leaving" their block (e.g. if you are using only 20-39 and the program defaults to 1140, you would have to realize that and change it to 1220).

To accomplish this, the _info table would store

• variable: serial_pools, value: comma-separated list of wards
• for each ward, a variable "Serial_pool" & <ward> (e.g. Serial_pool_HSC_H4H) with the most recent value used, updated automatically by the serial wizard

• Any thoughts about this? Do you think it would/wouldn't work or be helpful? Especially, do you think collectors would consistently "catch" the ends of blocks?
  • This may not work as planned as there are times when the data collector assigns a number to a patient file in her log book but is unable to use it immediately and must use numbers out of order (even though the numbers are assigned in the right order).--CMarks 08:39, 30 November 2010 (CST)

Facilitate exchange of patient discharge times

We discussed at the last collection meeting that I would set up a program to provide the collectors with admit/discharge info. We discussed whether to include Comos etc. in this, and it was decided not to - Julie will from now on treat ANY como on this admisssion as a como for all subsequent ward stays on that admission. (see also Admit, Transfer and Discharge date and time) Template:Discussion

• Trish - did I get that right, shall we proceed? Ttenbergen 14:59, 20 October 2010 (CDT)
  • I thought you, Tina, was going to set up something so we could at least track discharge times and not have to email coworkers esp in other sites. DKlopick
    • That was what I was trying to confirm. I re-worded it to be clearer. I need to know if we did actually decide that you would no longer compare comorbids. Trish? Ttenbergen 10:02, 25 October 2010 (CDT)
      • When I spoke with Julie last week she said we did not have to compare comorbids any more. Julie please confirm this on the wiki. --LKolesar 15:02, 19 November 2010 (CST)

Facilitating diagnosis entries

As discussed at the Meeting Laura Kolesar is reviewing the names of the diagnoses we use to make it more likely that you get the right one when you start typing. Laura, any progress on this? Ttenbergen 19:24, 30 December 2010 (CST) Template:Discussion

Extra "pathogens"

Unknown Pathogen

• MWaschuk 17:46, 9 June 2010 (CDT)

As part of an effort to reduce relying on paper notes during collection, Marie brought up the possibility to put "waiting for tests" and "review" as options into the pathogen dropdown and to conditional-format the field in orange if they are chosen. Of course, choosing them would also disable checking DX complete.

• Would anyone else find this useful? Should it be included in the Master DB? Ttenbergen 17:34, 9 February 2010 (CST)
  • Yes, I would find this useful
    • I usually put unknown pathogen in my pathogen slot if waiting for results, then when rechecking the profile upon discharge, I re-check on the EPR for results again. If still no results, I generally do not hold the profile longer. I wonder what our policy should be on this. How long should we hold a profile for possible results? This could back up our flow of profiles quite a bit. What does everyone think?--LKolesar 15:08, 10 June 2010 (CDT)
      • I do the same as Laura. DPageNewton 17:11, 2 November 2010 (CDT)
• At HSC we wait 5 days and if no results back we send the profile.--CMarks 08:19, 3 November 2010 (CDT)

Changes to the ccmdb.mdb to reduce reliance on paper

The "extra pathogens" entry above makes me wonder: are there other features collectors can think of that would suddenly make it more desirable to enter data electronically in the first place rather than on paper? This question really only applies to the access program (e.g. to laptop users) since we are phasing out the PDAs and I am not going to make any modifications to them because they cause cascading problems.

• Any thoughts? Ttenbergen 17:34, 9 February 2010 (CST)

Bugs that need replicating

In order to troubleshoot a bug we need to know a way to "make it happen". This section contains bugs that have been reported but can not be demonstrated on demand.

Infection without pathogen subcode was sent to csv

Oaks - Patient coded for Cystitis Bladder Infection but no sub code? Admit date Jan 25/10-Jan. 30/10. Pagasa Torres.

Patient coded for Cystitis Bladder Infection but no sub code; Admit date Jan 25/10-Jan. 30/10.

Asked Wendy if there was any extraordinary edits for this pt, and she replied "Nope and I too am surprised as it has always been caught if I miss it in the Edit Patients pane??? I just simply forgot as I was awaiting the results...have no idea how it got sent???"

How to demonstrate this bug

• Anyone? Ttenbergen 16:59, 9 February 2010 (CST)

Previous requests that were not addressed (with reasons)

Default location field to main collection location

There have been requests to default the location field to the main (or only) collection location. I could set this up, but defaulting these would increase the chances of the data just being left in there if a patient is an exception. Upon consultation with Trish it was decided not to risk an increase in errors to make this more convenient.

• "There are a number of site collecting on 2 or more units using the same laptop. We get ward location entry error when there is a default location set." ... "--TOstryzniuk 12:25, 20 October 2010 (CDT)"

Cancel for Settings

change the settings form to have a save and a cancel button...

No can do. There are is a sb-form in settings form that would not be cancelled, so having a cancel would be misleading.

Off-line copy of wiki for laptop

We found a way to do this, but it would add overhead work to the collectors' job and it would deter from using the wiki as a tool owned and updated by all, so Trish and Tina decided not to pursue this further. Ttenbergen 15:01, 16 April 2010 (CDT)

• look into possibility of automatically downloading WIKI guide to laptop each day that it is synch'd. (portable version of guideline)--TOstryzniuk 20:11, 4 April 2009 (CDT)

• As moved from Diagnosis Coding:

A suggestion has been put forth to Tina is to find a away to allow a downloaded copy of the WIKI guide on laptops, the collection tool we are moving to soon. I think this would be an excellent solution if she can do this. Collectors would then be able to search for info no matter where they are in the collection field and each time they synch there laptop, they would get updated WIKI items. That is the plan............but waiting to here from IT support.

It is challenge right now in that the guideline information is not easily and quickly accessible while you are doing your work in the unit or in medical records. Most collectors must run back to their office or find a free computer to log in and look up guide info.

Keep in mind, guide information changes regularily, so what you print out one day is outdated the next for a number of articles. TOstryzniuk 11:25, 29 April 2009 (CDT)

• April 2010 - Trish and Tina reviewed the apparent option to have a COPY of wiki on laptop. Problem if implemented:

1. if collectors will not have the most update the copy on laptop because changes and updates are happening daily on the MAIN copy here, and thus changes to instruction will get missed.
2. 2. Don't want multiple copies of instruction and information on multiple laptops that are not up to date.
3. Collector questions and contribution to the Wiki cannot be added to copy of Wiki on laptop. Questions and contribution must be made centrally not locally so that information is in ONE PLACE and the same for everyone.--TOstryzniuk 19:11, 20 April 2010 (CDT)

APACHE lab value limit change request

• Apache upper limit for creatinine is 2968, which is based on the highest APACHE that was ever in database. STB has one pt with a creat of 3000 and has requested to change upper limit. Laura K. --TOstryzniuk 12:12, 6 July 2010 (CDT)
  • Decided to leave limits be and have collectors enter limit values and email Pagasa with real values when extreme values are encountered. Contacted Pagasa to let us know if such emails become too frequent. Ttenbergen 08:53, 12 July 2010 (CDT)