2020-04 HSC COVID unit transition

This page is about the April transition of collection units at HSC to accommodate the new COVID unit. See 2020-03 HSC COVID unit transition about earlier transitions and 2020-05 HSC COVID unit transition about later ones.

Background

Dates

• Wednesday April 1- HSC_H4 patients moved to HSC D4 as suspect COVID cases (HSC_H4 closed for terminal clean)
  • all HSC_H4 patients were moved to HSC_D4_C and were all considered as covid suspects. and they are the ones who were now labeled as D4 suspects who later move to "HSC D2 C" in Apr 3. the ones left at HSC_D4_C are all COVID+. HSC_H4 is vacant from April 1 forward
• Friday April 3 - D4 Suspect patients moved to D2 Covid Suspect ward (D4-C is now the COVID positive ward)
• Tuesday April 7 - Boarding Loc beds HSC B2B moved to HSC WRS2
• Tuesday April 7 - "HSC D2 C" opened as COVID-19 suspect ward
• Tuesday April 14.20 – patients in HSC_H4H (GH7 HOBS) moved to HSC_B2
• Wednesday April 15 -HSC_H4 reopened
• July 27.21 - B2B only COVID ward open at HSC

Medicine specifics

Cut-off dates

• Julie wrote - We should have a cut-off date for the additional covid ward D2 and MS3. As I understand these new wards are for covid positives. Once dates are confirmed, then we start collecting at D2 and MS3.
  • Currently D2 is still a suspect ward, D4 is still our only COVID + ward Lisa Kaita 17:01, 2020 April 16 (CDT)
    • update There are no COVID specific suspect or positive wards as of May 27, 2020 Lisa Kaita 13:49, 2020 June 11 (CDT)

multiple wards

• If all the covid wards are operational, how to handle the case where the patient stayed in 2 official covid wards consecutively - 1) separate records or 2)one continuous record? I think we should consider (2) as continuous. (who asked?)
  • what was the decision? Ttenbergen 10:31, 2020 May 14 (CDT)
  • Did not happen at all. we can ignore this scenario. --JMojica 10:00, 2020 June 12 (CDT)}}

ICU specifics

April 2020 HSC_MICU will admitted both SICU and MICU physician Service patients that are either suspect or confirmed COVID patients. No suspect or positive covid will be admitted to HSC SICU. Though MICU is a close unit the SICU patient in this unit will be under the SICU attending service physician. Depending on skill set required, sometime may be a SICU nurse or just MICU nurse. The nurse bit we will not be able to track.

• This scenario can be handled by our tmp boarding loc. Say an SICU physician service patient with COVID using HSC MICU bed will have SICU as service and boarding loc at MICU. OR vice versa, no covid MICU physician Service patients using SICU bed will have service MICU and boarding loc at SICU.

Wards involved:

• • "HSC D2 C" - stopped May 12.20
  • HSC_B2
  • HSC_MS3
  • HSC_A7_MI
  • HSC_A7_SI
  • HSC_H7_MI
  • HSC_H7_SI

originals:

• HSC_H4H
• HSC_MICU
• HSC_SICU
• HSC_IICU

Multiple Units

Related to ICU, how will the patient originally at HSC_MICU then move to either H7 or A7 under the care of MICU be collected - will the move to H7/A7 be a new record or continuation?

• the move will be considered as a continuation of HSC MICU profile and H7 or A7 is noted as a second record in tmp boarding loc.

Tmp entries

• The following should be added to Tmp entries :
  • HSC_D5_P
  • HSC_D4_P
  • HSC_H4H

Transition plan

1. There is no transition plan for the new COVID wards and the additional ICUs. Just need to add in the s_dispo table
2. This transition plan is only for the patients in H4H who were moved to HSC_B2
   • "HSC_H4H" needs to be added to s_tmp table of Project BoardingLoc

collector instructions

1. change the Service/Location of the record to the new location (ie from HSC_H4H to HSC_B2 )
   • Multi DC are collecting the H4H patients
     • HSC_H4H_a to HSC_B2
     • HSC_H4H_b to HSC_B2
     • HSC_H4H_d to HSC_B2
     • HSC_H4H_h to HSC_B2
   • the new ward B2 does not need a subscript anymore because the Laptop identifier replaces it.
2. enter the actual location as part of Boarding Loc:
   • for patients who had no location borrowing during transition:
     • change the "no borrow" line to "HSC_H4H" and enter the time the patient arrived in H4H
     • add a line for "HSC - Home medicine ward" with the time that the patient was actually moved
   • if there were patients who actually were in a borrow location during the transition, let's talk about how we would enter those
     • The move from H4H to B2 happened April 14th.

D2 COVID Suspect Ward "HSC D2 C"

• Stopped May 12.20. will be Ortho.

This ward is a mix of different medicine patients ie. H, D, A, unkknown, and nephrology patients, therefore each data collector will enter their own patients

1. the Service/Location will be your home ward location
2. in the tmp the Boarding Loc will be generic boarding and in Q column enter D2
3. if the patient's result is negative and they are moved back to their home ward then enter Boarding Loc HSC home medicine ward with the date and time they are transferred back
4. if the patient's result is positive, create a new profile using D4_C or whichever COVID + ward they are transferred to, if they remain on D2 no changes are required

Special Circumstances

When Reviewing a chart in MR and you find a COVID positive or COVID suspect patient that occurred BEFORE the new COVID positive/suspect wards were opened, use Service Location home ward location and use the appropriate COVID-19 (SARS-COV-2) or Observation for suspected infection NOS code.

When reviewing a chart in MR and you find a COVID suspect patient on your home ward and the patient is transferred to another location where the diagnosis of COVID positive is made, check the date/time the swab was sent. If it was sent less than 48 hours after admission code this as an Admit Diagnosis, if the swab was sent greater than 48 hours after admission code this as an Acquired Diagnosis

Serial Number

1. For transition units ie. D5 to WRS3, D4 to D5, H4H to B2, use your continuous serial numbers
2. For D4_C start with serial number 150

Reporting

• service location HSC_H4H before April 14,2020 and HSC_B2 can be together.
• all COVID wards namely HSC_D4_C, "HSC D2 C", HSC_MS3 can be together.
• HSC_MICU, HSC_A7_MI, HSC_H7_MI can be together.
• HSC_SICU, HSC_A7_SI, HSC_H7_SI can be together.

Cross checks

• CCMDB.accdb Data Integrity Checks for Boarding Loc have been set up. Ttenbergen 10:26, 2020 June 25 (CDT)