Accept DtTm field

The Accept DtTm field contains the date and time when the attending physician accepts a patient from the ER department ONLY. This is applicable for both ICU and Medicine Database Program

Collection Instruction

Only for patients admitted from the ER department.

If there is a record of the date/time that the service physician accepted the patient, enter this as the Accept DtTm.

If there is no clear record of the accept date/time, enter the Arrive_DtTm field and then click the "set accept_DtTm to Arrive_DtTm" button to copy the DtTm across.

If the Accept DtTm > Arrive DtTm, make accept = arrive

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
• hospital admission sheet (e.g the white admission separation?/triage sheet at HSC)
• 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)

When does collection start?

see

• Definition of an ICU admission
• Definition of a Medicine Service admission

Question

• Does this include a patient who is transferred for a procedure from the local ER eg)cardiac cath, EEG, CT angio PRIOR to being transferred back to the ICU? For example, a patient is sent from the ER to St. B for cardiac angio with presumed STEMI. The prior location in this case would be St. B cath lab. At some facilities, the patient is accepted to ICU prior to the transfer to the procedure. So, does this patient originate from the ER- allowing the collector to put in the accept date/time or is it blank as the patient is coming from the cath lab? --Lpruden2 11:23, 2016 July 4 (CDT)
  • I think this is more of a Previous Location question, no? Because there it says "most recent previous physical location". So, if pt spent time in ER on way back to you, then previous location is ER, and you need an accepted DtTm. I wonder if this is related to Cath lab. Ttenbergen 11:45, 2016 July 4 (CDT)
  • If coming from Cath lab prior to ICU, the accept date/time should be blank. The rationale for recording accept date/time is to determine the wait at ER before the physical arrival at ICU or Med ward. If we will enter the accept date/time and determine the delay between arrive date/time and accept date/time, the amount of delay will include the time spent undergoing a procedure at STB cath lab which is not correct. JMojica 12:08, 2016 July 4 (CDT)

Data Use

Patient flow

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

Template:CCMDB Data Integrity Checks

• Function Dispo Chronological()
• Function long LOS()

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.

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).