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.
OR Admissions
To be admitted from an OR, the primary admit diagnoses must be the procedure they were in the OR for. See Check ORDx for more info.
STEMI from home (zz) to St Boniface
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. Template:Discussion
- This isn't done on Medicine at HSC unless it says Direct. Some of the ICU data collectors feel we no longer need to code the hospital prior to your ER. Does anyone out there know if this rule still applies? Does anyone know if there are rules for Medicine and then different ones for ICU? For example if a patient is in Brandon Hospital ICU comes to your ER then to your ICU. What are people putting? your ER or Brandon ICU? Has anyone had this discussion with Trish?If a few people answer consistently I will remove this discussion.Thanks!GHall 16:18, 8 August 2011 (CDT)
- I have recently had this discussion with Trish and also have spoken with Alan Garland in our task group meetings about this issue in the past. Alan had wanted the originating hospital because it can sometimes reflect outcomes. For example: if a pt first presents at a rural hospital and needs to be transferred to a tertiary hospital the time in transit could mean a worse outcome for the pt. Also presenting to a community hospital with a condition that requires tertiary care like a heart cath does delay the timing of the procedure and could compromise the outcome in some cases.
When I spoke with Trish recently she was unclear about this but told me to clarify with Dr.Garland. I did send him an email to try to be absolutely sure, but I have not heard back from him. He may be on vacation. I will follow this up in September when the task group meetings resume. Thanks for questioning this . If anyone has anything further to add it would be good to get this discussion prior so that I can present everyone's views. --LKolesar 14:16, 9 August 2011 (CDT)
- Thanks Laura for your response. Until we get it straightened out I will put patients coming from another hospital as admitted from that hospital even if they come through my ER. That way Dr Garland gets his info.GHall 19:58, 9 August 2011 (CDT)
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 Hospital previous put the center that they had been sent from.
From OR to other hospital via PACU
If a patient is admitted at site-A ER, transferred to site-B for a non-angio procedure, it is determined in site-B PACU that they need an ICU bed and they are transferred to site-C ICU, then code as admitted from site-B Recovery Room.
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
Template: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()))
________________________________________
Legacy
Previously used guideline decision to not use this June 8, 2011: 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.
Data Structure and details
S AdmitDischarge is the table which contains the list of the most current values in CCMDB.mdb.
Acceptable Data
- It is important for data collectors to be aware that the letters used in the section below are not on the laptops and are only utilized by Julie, Trish, Pagasa and others who process the 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