Previous Service field

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This field is currently being implemented, please check the instructions and put a discussion for anything that isn't clear.

The Previous_Service field contains info about the service taking care of the patient prior to admission to the current location.

Purpose

The purpose of this field is integrate the "sending service" or "originating service" for those patients's who where already in a prior inpatient location before coming to the ICU and the patients coming from the Emergency Department and were accepted to Medicine service.


  • the first part of the purpose is mainly used for the Critical Car Program (refer to Task Meeting Minutes April 13,2015).

Note: This is different to the "service of the attending" during the patient's stay in ICU or Ward.


Collection Instruction

For each patient,

  • enter the option that most closely matches
  • for medicine ward-to-ward moves, enter "medicine" as previous service (can't just omit because then we would not know if omitted intentionally")
  • if the service is not listed, code “other”
    • in these cases we don't care about the details; if we see too many others we may add additional options in future
  • if previous service is not applicable, enter not applicable
    • Template:Discussion under what circumstances would that be? Ttenbergen 12:14, 2016 March 21 (CDT) Ttenbergen 20:08, 2016 April 18 (CDT)

Questions

Medicine Ward to Ward

Template:Discussion

  • because this field is related to ER wait in medicine it will be left blank when a pt is transfered for example from B3 to D4? Judy K
  • Since this field is related to er wait in the medicine program do you want this field used when the pt transferes from D4 to A3 to D5 (medicine to surgery to medicine)? Judy april 13th, 2016.
  • If it is medicine service sending the pt do you still need to fill this field in for the medicine program patients, or only if they come from a different service?--LKolesar 14:29, 2016 April 14 (CDT)
    • updated the instructions above to address this, if now clear please remove this section. Ttenbergen 16:02, 2016 April 18 (CDT)

Medicine Patients Ward to Ward

Template:Discussion

  • for Medicine pts ER to ward, would the previous service be Emergency Medicine or Medicine as pt was accepted to Medicine service in ER?
    • good question, we need to find out Ttenbergen 19:34, 2016 April 25 (CDT)

ICU to ICU moves

Template:Discussion

  • If a patient comes from the ICU to the ward, or ICU to ICU, are we still entering "not applicable", or are we supposed to start entering something more specific (surgical/medicine/etc.)Mlagadi 15:31, 2016 April 18 (CDT)
  • "I do not see Critical Care Medicine?" Lou
    • Julie, thoughts on how ICU-to-ICU should be collected in new scheme? I could add "not applicable" or "Critical Care Medicine" or something else. Thoughts? Ttenbergen 20:05, 2016 April 18 (CDT)

ICU to Medicine move

Template:Discussion

  • "I do not see Critical Care Medicine?" (Lou)
    • emailing Julie to decide how we want to handle that... Ttenbergen 18:35, 2016 April 18 (CDT)

Direct Admission / from ACF

Template:Discussion

  • there is the option of "direct admission" under the previous service, so if a patient comes from ambulatory care clinic direct to the ward do we select direct admission or the service they saw in amb care? Lisa Kaita 08:46, 2016 April 15 (CDT)
  • There is no option in the drop down for a patient coming from ACF. Previously, we would just put "not an inpatient" but this option is not in the selection. (This is for the ICU people). --LKolesar 10:04, 2016 April 15 (CDT)
  • Can you add Cancer Care/Oncology and Infectious Disease as we get frequent admissions from them?--CMarks 12:48, 2016 April 11 (CDT)
    • Interesting question; the intent there was just to replace the "direct admit" from ER Wait. But what should be the right entry? Will need to look into this. Ttenbergen 16:02, 2016 April 18 (CDT)

Data Use

Used to be:

Template:CCMDB Data Integrity Checks

None as of 11:58, 2016 March 21 (CDT).

Implementation

The field is populated with options from the s_previous_service table.

Legacy

For medicine this concept is related to ER Wait.

For critical care this concept is related to Service Sending to ICU.

for tracking which service is taking care of a patient in STB CCU, see CCU Service Tracking instead

COPY FROM SENDING SERVICE USING THIS TO UPDATE THIS ARTICLE

bELOW WILL GET REMOVED AS IT IS UPDATED INTO ARTICLE ABOVE.JMojica 15:54, 2016 April 26 (CDT)

Purpose

To identify the "sending service" or "originating service" for those patients's who where already in a prior inpatient location before coming to the ICU. (refer to Task Meeting Minutes April 13,2015). Note: This is different to the "service of the attending" during the patient's stay in ICU.

Data Collection Instructions

When you enter a new ICU patient a "Srv to ICU" will be automatically generated with item zz_enter. Before you can check the tmp checkbox this item has to be changed to one of the following:

  • one of the sending services as per dropdown if applicable
  • z_not an inpatient - if the patient was not an inpatient, eg came from home, usually only happens in CCU e.g. if STB cardiologist admits based on phone call; this is not for pts coming from angio, these would be from service cardiology
  • z_not applicable' - pt moving from one ICU to another (including from CCU, don't use cardiology for this)
  • z_other - any others such as EENT surgery at STB
  • z_unknown - if unknown service for patients coming from ward or OR or RR
  • - the entry automatically put in for new CC patients, not accepted as final entry when checking tmp checkbox

The other tmp fields are not used (except in "not applicable" scenario)

special case - ER -> OR -> ICU

  • Scenario: The service is consulted in emergency, an OR or procedure is planned and an ICU stay is planned post-op but the patient was not on an inpatient ward.
  • Collection: If the patient had been accepted to a service, ie admitted and therefore now an inpatient, even if they were still physically in the ER, then code Service Sending with the specific service.

Template:Discussion Would pt ever go to OR without having been accepted? Ttenbergen 17:39, 2016 March 21 (CDT)

How to determine?

Go and find out. Ask on the ward. Talk to people. In EPR there is a pt provider section that shows what service(s) the pt has been under, as well there is often an indication of service change in the EPR orders section.

Start/End Dates

  • Start: 2015-06-22
  • End: there is no planned end date

Template:CCMDB Data Integrity Checks

When you enter a new ICU patient a "Srv to ICU" will be automatically generated.

  • If that record is missing, you can't checkbox tmp
  • If that record has "enter" or "" as item, you can't checkbox tmp

currently impossible

  • Query s_tmp_Service_Sending_to_ICU_duplicate - error if more than one entry per patient Ttenbergen 15:35, 2015 June 22 (CDT)
  • Query s_tmp_Service_Sending_to_ICU - Error if:
    • not admitted from inpatient location ((S AdmitDischarge.inpatient = true)) but has "Srv to ICU" entry
    • admitted from inpatient location and one of
      • no "Srv to ICU" entry
      • has "Srv to ICU" = "z_not applicable" and no comment

Right now our consistency check would not allow someone from other hosp via ER. We won't be able to do this check until we have Pre-admit Inpatient Institution field. I will take that check out for now. Ttenbergen 11:50, 2015 June 24 (CDT) Template:Discussion

SAS Program

  • The data is saved in table L_TmpV2 under project "Srv to ICU" of the centralized_data.mdb
  • The SAS program that reads the data is in X:\Julie\SAS_CFE\CFE_macros\CFE_ServiceSendingtoICU.sas

See also

to do before go live

  • Registry_Patient_Type#C-Cardiac_Type - awaiting confirmation
    • "Once this tmp study section is active we can go back to making the pt type relate to the type of diagnosis." (Laura K)
      • need to look into Ttenbergen 16:58, 2016 March 21 (CDT)

why a STB CC topic?

Template:Discussion why would this be in the STB Critical Care category specifically? Or the Site Specific Collection Guide? If not answered by next review I will remove category. Ttenbergen 16:58, 2016 March 21 (CDT)

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