Accept DtTm field: Difference between revisions

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** Because we are only collecting this for patients admitted from your own ER department, the inpatient demographic sheet admit time should always reflect the current admission to either medicine or ICU. [[User:Lkaita|Lisa Kaita]] 10:45, 2017 May 4 (CDT)
** Because we are only collecting this for patients admitted from your own ER department, the inpatient demographic sheet admit time should always reflect the current admission to either medicine or ICU. [[User:Lkaita|Lisa Kaita]] 10:45, 2017 May 4 (CDT)
***Gail has pointed out that at her site, where we do not collect medicine, a patient could be initially accepted under medicine in the ER and then deteriorate and are then accepted and transferred to the ICU.  The previous location would indicate ER (at sites where medicine is collected this would indicate EMIP) , the previous service would be medicine,  would Gail still enter an accept time? or is this an exception to the rule since they were accepted under another service first while in ER?  Patients could also potentially be accepted by other services in the ER, eg. surgery, and then switch to medicine or ICU, so is an accept time required for these patients? [[User:Lkaita|Lisa Kaita]] 10:43, 2017 May 9 (CDT)
***Gail has pointed out that at her site, where we do not collect medicine, a patient could be initially accepted under medicine in the ER and then deteriorate and are then accepted and transferred to the ICU.  The previous location would indicate ER (at sites where medicine is collected this would indicate EMIP) , the previous service would be medicine,  would Gail still enter an accept time? or is this an exception to the rule since they were accepted under another service first while in ER?  Patients could also potentially be accepted by other services in the ER, eg. surgery, and then switch to medicine or ICU, so is an accept time required for these patients? [[User:Lkaita|Lisa Kaita]] 10:43, 2017 May 9 (CDT)
**** the rule will still holds for any patient who spent time in ER whether under ER service or other services prior to acceptance to Medicine or Critical Care service. --[[User:JMojica|JMojica]] 11:37, 2017 May 10 (CDT)
=== Direct Admissions/Transfers ===
=== Direct Admissions/Transfers ===
For patients who have been accepted from another hospital '''but have a wait time in ER''' (who used to be called Direct Admissions/Parked in ER), use the triage date and time for the Accept Date and Time as it is clearly marked on the triage sheet. The Visit Date and Time (found in EPR) may actually be later than the accept date and time, so don't use it as your Accept DtTm.
For patients who have been accepted from another hospital '''but have a wait time in ER''' (who used to be called Direct Admissions/Parked in ER), use the triage date and time for the Accept Date and Time as it is clearly marked on the triage sheet. The Visit Date and Time (found in EPR) may actually be later than the accept date and time, so don't use it as your Accept DtTm.

Revision as of 11:37, 2017 May 10

Data Element (edit)
Field Name: Accept DtTm
CCMDB Label: Accept DtTm
CCMDB tab: not stated
Table: L_Log
Data type: date
Length: not stated
Program: Med and CC
Created/Raw: Raw
Start Date: 2016-07-01
End Date: 2300-01-01
Sort Index: 43

The date and time when the patient is accepted from the ER department ONLY.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


2017 Jan: also see: AcceptDateSource

Collection Instruction

Only for patients admitted from your own ER department enter the date/time that the service physician accepted the patient, leave blank for all others.

Template:Discussion

  • The ICU standing orders at the Concordia are always written after the patient arrives.If I use those orders as the accept DtTm because no other time prior to this exists, then the accept would=arrive?GHall 08:00, 2016 October 31 (CDT)
    • Is there a different source you could use that would give better information? See #Possible documentation locations for ideas and update there if necessary. Ttenbergen 10:37, 2016 October 31 (CDT)
  • I would use a different [[[AcceptDateSource]] like prior orders,consult sheet, progress note documentation except it rarely exists at the concordiaGHall 10:55, 2016 October 31 (CDT)
  • Do you want us to use the time on the inpatient demographic sheet for the accept date and time even if this doesn't specify an ICU admission? ie presumed accept time?
    • Because we are only collecting this for patients admitted from your own ER department, the inpatient demographic sheet admit time should always reflect the current admission to either medicine or ICU. Lisa Kaita 10:45, 2017 May 4 (CDT)
      • Gail has pointed out that at her site, where we do not collect medicine, a patient could be initially accepted under medicine in the ER and then deteriorate and are then accepted and transferred to the ICU. The previous location would indicate ER (at sites where medicine is collected this would indicate EMIP) , the previous service would be medicine, would Gail still enter an accept time? or is this an exception to the rule since they were accepted under another service first while in ER? Patients could also potentially be accepted by other services in the ER, eg. surgery, and then switch to medicine or ICU, so is an accept time required for these patients? Lisa Kaita 10:43, 2017 May 9 (CDT)
        • the rule will still holds for any patient who spent time in ER whether under ER service or other services prior to acceptance to Medicine or Critical Care service. --JMojica 11:37, 2017 May 10 (CDT)

Direct Admissions/Transfers

For patients who have been accepted from another hospital but have a wait time in ER (who used to be called Direct Admissions/Parked in ER), use the triage date and time for the Accept Date and Time as it is clearly marked on the triage sheet. The Visit Date and Time (found in EPR) may actually be later than the accept date and time, so don't use it as your Accept DtTm.

Possible documentation locations

  • admission/separation registers
  • EPR
  • use the date and time from the "accepted to service" on the EPR orders. i.e. in the epr, click on orders, then highlight the order that says "admit to inpatient-medicine-medical service". Right click on that order. Scroll down to view, then across to history, then across to status. Click on status. Use the date and time as listed in the top "new" order. This is the date and time the patient is accepted to medical service.
  • Physician Order sheet
  • the IPN (integrated progress note) which is a hand written admission note by the nurse. We at HSC in medicine use this.--CMarks 08:10, 26 January 2012 (CST)
  • consult sheet
  • history and physical

When does collection start?

see

Data Use

Patient flow

  • medicine program: to monitor delays to move patient from ER to Med ward bed
  • as of July 2016 onward - ICU same purpose

Accept DtTm is used as part of the formula to calculate delay in the transfer of patient from ER bed to Med ward or ICU bed - see ER Delay. This measures the amount of time for the patient already accepted in Medicine or Critical Care service but still using the ER bed and resources.

Template:CCMDB Data Integrity Checks

Legacy

This field is part of the 2016 Time and Place changes.

For medicine this concept is related to admit date and time (when pt is from ER). It does not simply replace the field, so this value still needs to be entered for patients not from ER. Resp. field L_Log.R_AdmDate and L_Log.R_AdmTime

For critical care this concept is related to Service Sending to ICU. (There is no comparable field in ICU for this in the old system).