Admit From & Discharged To
The Admit From value defines the location from where a patient was admitted from. The Discharged To value defines the location that a patient was discharged to.
Special Cases
Deceased patient
Discharge-to must be left empty for deceased patients.
STEMI Admisssion from home
Occasionally a patient is picked up by paramedics at home and transferred directly to the heart cath lab at St. Boniface Hospital. They will not go to ER first to facilitate a very rapid "primary" PTCA. These patients are then sent from the heart cath lab to CCU at STB or HSC. In this scenario, code 'admit from' home and # diagnosis is angiogram or angioplasty (only exception is a cardiac arrest or cardiogenic shock which would be #1 and the angio would be #2). --LKolesar 19:11, 1 November 2008 (CDT)
From other hospital via ER
If a patient is admitted to another hospital first, then transferred to your ER, then is sent up to unit, code that they were admitted from another hospital not your ER. Also indicate this in the Hospital Number Code box. If a patient comes from another hospital, goes to ER, then to OR, then to your unit code as admitted from OR, but in the hospital previous field put the center that they had been sent from.
From other hospital via Angio
If a patient comes from another center to angiography in your center, then to your unit, please record which site the patient was from prior to angiogram and in the hospital number code box put the center that they had been sent from.
Patient transferred from OR to other hospital via PACU
- I have a pt that started at St B ER and was transferred to HSC for a nephrostomy tube. While the pt was in the PACU the ICU attending determined that she needed to be transferred to a monitored bed and she was admitted to our ICU. So technically she came to us from HSC PACU, but do I treat this in the same manner as an angioplasty? Should I admit her from St B ER? And does this qualify as a medical or surgical admission? She had severe sepsis and pyleonephritis. BDeVlaming 09:17, 30 April 2010 (CDT)
- if you are going to use the nephrostomy tube as an admit 1 somehow you will likely need an OR location as admit-from, or you will get an error. Not sure if that will help. Also, make sure you use {{discussion}} when you post a question so it gets categorized and marked with that questionmark book. Ttenbergen 16:05, 30 April 2010 (CDT)
- Admit from is HR (HSC Recovery room).--TOstryzniuk 18:34, 4 May 2010 (CDT)
- if you are going to use the nephrostomy tube as an admit 1 somehow you will likely need an OR location as admit-from, or you will get an error. Not sure if that will help. Also, make sure you use {{discussion}} when you post a question so it gets categorized and marked with that questionmark book. Ttenbergen 16:05, 30 April 2010 (CDT)
Direct to Medicine from Ambulatory Care
DIRECT to Medicine are patients who the medicine service attending Dr. has already accepted to their service, but the patient is sent to the ER to wait for a ward bed.
Example of Direct to medicine from ambulatory care clinic: Admit FROM: HA Medicine service Accept date (date and time admitted to medicine service): is the date and time patient came to ER MOVE 1 – date and time patient actually arrived on the ward Comment for MOVE 1– type in as follows: parked in ER
If a patient is sent to ER from ambulatory care to be assessed by Medicine Service in ER to see if he should or should not be admitted to a med ward bed, then this is not a direct admission to medicine. Admit from is HE.
Organ Donor/Braindead
Specific procedures apply, see Organ Donor article for details
Data Integrity Rules
- No discharge to current hospital's ER from anywhere (implemented by Function DisTo_Emerg())
- If medicine patient admit from ward, we need Med Var 1 - Admit-from Ward (implemented by Function AdFrom_Var1_reconcile())
- If medicine patient discharge to ward, we need Med Var 2 - Discharge-to Ward (implemented by Function DisTo_Var2_reconcile())
- For survived patients, Discharged-to should never be blank (implemented by Function DisTo_Dead()))
Discussion - Admit from ZZ and move
- I have seen a few patients in the database, who have admit from ZZ, yet they have a moved date a few days after being accepted to medicine. Admit from should be HE not ZZ if there is a move. If I see this then it is being interpreted as a direct to medicine from home but parked in ER. Does this happen? Let me know. (as per note from Trish from Dec 10.07)
- Well I know it's a long time since the above question was asked but occasionally a patient is to be direct to medicine from home but are parked in ER. How would you like this coded?
Discussion - Discharge to ER
- From: Gail Hall
- Sent: Friday, March 12, 2010 12:34 PM
- To: Trish Ostryzniuk
- Cc: Tina Tenbergen
- Subject: discharge to emergency
- Hi:Patient 1781 from H4H was discharged to SOGH emergency and was parked there waiting for a bed. The program doesn't allow you to send if the discharge is to ER so I put ward(SOGH). We are very tight for beds and I expect this to happen again. Gail Hall
- Before medicine service sends a patient from a med ward here, to a med ward in another hospital, there must be some discussion between physicians in both centers and, the physician on the receiving end of the transfer, must have “accepted” the pt.
I don’t think Medicine service wards just pack people up and dump them in other centers ER’s and hope for the best on the other end? It is likely the physician at the Oaks who accepted the pt, wanted them sent to the ER first so her/she could assess. Technically this patient is still a continuous hospital admission in the Region.
- For example, if we were collecting data at the Oaks on a medicine ward, this patient would be a transfer/admit from a HSC ward to a Oaks ward, with a “park in ER” at the Oaks. This would not be an admission from the Oaks ER. If Oaks med ward codes; admit from ER, then it would appear to be a new admission to the hospital system in the city rather than a continuous hospital stay in the Region.
- Dan or Julie, if you have anything more to add to this…………thanks.__TOstryzniuk 19:07, 18 March 2010 (CDT)
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Data Structure and details
S AdmitDischarge is the table which contains the list of the most current values in CCMDB.mdb.
Acceptable Data
These values always consist of two characters. The first letter designates the facility, the second letter the location in the facility.
The meanings for the codes are as follows.
- Special Note: For patients who were admitted from a hospital outside of Winnipeg, also see the entry for hospital previous.
First Letters / Hospitals
| Hospital/Site | First Letter |
| HSC | H |
| St Boniface | B |
| Grace | G |
| Victoria | V |
| Concordia | C |
| 7 Oaks | K |
| Children's Hospital | P |
Second Letters / Locations
| Location | Code Key | Notes |
| Ambulatory Care | A | Out pt dialysis, Day clinic, Day surgery, Cancer Clinic etc. (added Nov 24.04) |
| Ward | W | |
| CICU | V | St Boniface only |
| Emerg | E | |
| CCU | C | HSC and STB only |
| Operating Room | P | |
| SICU | S | Only at HSC and StB |
| MICU | M | |
| IICU | U | HSC only |
| Recovery Room | R | |
| Location Unknown | X |
Special Locations where only limited combinations are allowed
| Misericordia Urgent Care | ME |
| Misericordia Ward | MW |
| Nursing Home | NW |
| Deer Lodge | DW |
| Riverview Center | RW |
| St Amant | AW |
| HOME | ZZ |
Non-Winnipeg Codes
- For any non-Winnipeg codes, the “hospital previous” number code must also be entered. (see Hosp number code table).
| Outside City | X* |
| Outside Province | Y* |
- Outside City Emergency XE
- Outside City MICU XM
- Outside City Operating XP
- Outside City Recovery XR
- Outside City Ward XW
- Outside City XX
- Outside Prov Emergency YE
- Outside Prov MICU YM
- Outside Prov Operating YP
- Outside Prov Recovery YR
- Outside Prov Ward YW
- Outside Province-Uknown unit YX