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.
Guidelines for the admit from source and discharge to location fields
It is important to obtain the correct location where the patient was prior to their ICU care and to distinquish between a pt that had been treated prior in any ICU or hospital ward as this can influence outcomes. The concept is that a pt that had prior inpatient care (ward or ICU) and still requires additional ICU care has a higher risk of death than someone who did not have prior care (coming from the community to ER). The following guidelines will apply:
- When ER is indicated as the admit from location, this implies that the pt originated in the community.
- If a pt has been treated in one or more ER's, just put the last one they were treated in.
- If a pt has been treated at any hospital ward or ICU inside or outside the city or province, it is important to capture this information, even if the pt went to your unit via ER for assessment. Your hospital ER in this case is just a triage area and not the original place they presented. For example: if a pt has been on the ward in Selkirk and is transferred to HSC ER and then is sent to HSC MICU, the admit from is Selkirk Ward, even though it is not a direct transfer.
- If a pt was bounced around a lot, then use the last ward or ICU as the source.
- PARR and the OR at any location can be used as admit from sources. It is not necessary to put the previous hospital code for these patients.
- The OR can be used as a discharge to location only if the pt is not returning to your unit. (Discharge to a different inpatient location following surgery).
- ER and ACF cannot be used in the discharge to field. If the patient goes to these locations, then the place they go after this needs to be put in the discharge to field.
- The heart cath lab is never used as an admit from or discharge to location. Where the pt was before and after this procedure needs to be recorded in these fields.
- If it is unclear what type of unit the patient is transfered to or discharged to put unknown.
Deceased (Expired) patients
Discharge-to must be left blank for patients who has expired.
- this includes Braindead Organ Donors that go to operating room (OR) for organ donation.
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 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
- 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()))
- For expired patients, Discharged-to should always be blank
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) |
| H6 ward at HSC | 6 | added Sept 25.12 - the only medicine ward in region at HSC that admits, LTV, MD, AML, failure to wean patients, etc. |
| 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