Pre-admit Inpatient Institution field

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

The Pre-admit Inpatient Institution field identifies the previous inpatient location of patients who were already inpatients elsewhere before coming to our unit. This does not include patients who just arrived at an ER elsewhere and were not admitted as inpatient there.

For example, a patient arriving from Selkirk Hospital via the local ER would have the ER coded in the Previous Location field and Selkirk coded in the Pre-admit Inpatient Institution field.

Collection Instruction

For each patient,

• enter the option that most closely matches
• if you know the situation but nothing on the list matches closely, enter other - known but not listed
• if the situation is unknown, enter location missing/unknown
• if the patient did not come from an inpatient location, enter "not applicable", for example if they came from home or a clinic. The ER is not an inpatient location.

If you know how we code the location exactly, you can type it. Otherwise press the "magic wand" button to take you to the S dispo chooser‎ to help filter options if desired.

Where to find this information

If patient came from a different Winnipeg hospital this will be recorded in the “Visit History” on the EPR.

Example

• ICU Vic---family medicine ward at the Vic---ED HSC---ED STB---cath lab---ICU HSC.
  • The PrevInptLocation field is: VIC_Ward

EMIP

If pt goes from Medicine EMIP to an ICU, use the EMIP location in Pre-admit Inpatient Institution field.

Ambiguous locations

The following are considered inpatient locations in this context:

• day-surgery patients ending up on our unit directly

The following are not considered inpatient locations, enter "NA / not applicable"

• care homes, including units with higher levels of care at Deer Lodge or Riverview

movement within the same hospital

If a patient gets transferred from one ward in a hospital to another ward, enter the previous ward as both the Previous Location field and the Pre-admit Inpatient Institution field.

Cath lab confusion

We did not use to collect cath lab and would instead code the location before, usually ER. We will now allow cath lab. If a patient comes from the cath lab it does not result in any other exceptional collection instructions. If they were an inpatient before, without interruption, code that location as Pre-admit Inpatient Institution field. If they were not an inpatient code it as not available.

Questions

Readmission from Grace/HSC Nursing Home

• currently discharges to and admissions from Grace Nursing Home are treated as new admissions (with the exception of the Discharge Screening Tool which is labelled 'transferred form'). Technically, though, this is an interhospital transfer, and the hospital treats it as a continuous admission. Will this require a previous Inpatient Institution entry? And will the visit admission date then be the original admission date, or the date transferred from one ward to the other? SCortilet
  • We treat these nursing home wards as inpatient locations for at least some scenarios. We will treat them as inpatient locations for this.
  • E.G.code Grace Nursing Home as Previous Location field and code Grace Ward (or e.g. VIC_S5 if known) as Pre-admit Inpatient Institution field.
  • Visit Admit DtTm field is the original hospital admit DtTm.

Data Use / Purpose

To document where those patients who were inpatients immediately before arriving on our ward/unit came from.

The detailed information will allow us also to distinguish between patients who were or were not inpatients before arrival. This is relevant to a patient's risk of bad outcomes.

The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.

Template:CCMDB Data Integrity Checks

Can not be blank.

Reports

Template:Discussion Which reports will this be on? Ttenbergen 10:33, 2016 March 22 (CDT)

Implementation

The field is populated with options from the s_dispo table.

Legacy

This field is part of the 2016 Time and Place changes and did not previously exist.

Nursing stations

We used to collect nursing stations in hospital previous but would not include them under the new scheme because they are not inpatient locations. Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.