Bed borrow: Difference between revisions

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== Currently collected concepts ==
== Currently collected concepts ==
* [[Boarding Loc]]
* [[Boarding Loc]]
* [[Accept DtTm]]
* [[Service tmp entry]]


=== Exception: [[EMIP]] ===
== Legacy concepts ==
{{DT | is this about to change with [[Boarding Loc]]? }}
The following concepts were collected separately before [[Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry]]:
EMIP patients are essentially bed borrows in the Emergency Room, but we collect and are specifically interested in this group, so follow the [[EMIP]] collection instructions for these patients.
* [[EMIP]]  
 
* [[Direct admit]]
=== [[Parked in ER]] ===
{{DT | is this about to change with [[Boarding Loc]]? }}
A patient is considered parked in ER if they are a direct admit but when they arrive a bed is borrowed in the ER. The location they came from is encoded as [[Accept Loc Park]].


== Background ==
== Background ==
The concept is important because it affects the [[Previous Location field]], [[Service/Location field]], [[Dispo field]], various cross-checks, and concepts like [[EMIP]], [[Boarding Loc]], [[Definition of an ICU admission]] and [[Definition of a Medicine Service admission]].  
The concept is important because it affects the [[Previous Location field]], [[Service/Location field]], [[Dispo field]], various cross-checks, and concepts like [[EMIP]], [[Boarding Loc]], [[Definition of a Critical Care Laptop Admission]] and [[Definition of a Medicine Laptop Admission]].  


=== Circumstances leading to bed borrows ===
=== Circumstances leading to bed borrows ===
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* post angio monitoring because pre and post procedure in angio is closed in late evening and night shifts.
* post angio monitoring because pre and post procedure in angio is closed in late evening and night shifts.
* medicine borrows a ICU bed for [[Cardioversion]]
* medicine borrows a ICU bed for [[Cardioversion]]
{{DiscussTask | Wouldn't "medicine borrows a ICU bed for [[Cardioversion]]" be a case of [[Bed holds]] instead of a borrow? Same for several others above...
}}


=== Considerations ===
=== Considerations ===
Bed-borrowing in other locations has always occurred but appear to becoming more common.  
Bed-borrowing in other locations has always occurred but appear to becoming more common.  
In the meantime, our [[Definition of an ICU admission]] stands and '''excludes''' bed borrows.


=== Implication: mis-estimation of workload ===
=== Implication: mis-estimation of workload ===
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== Legacy concepts, or considered but never implemented ==
== Legacy concepts, or considered but never implemented ==
* [[ECIP]]
* [[ECIP]]
* [[Moves for Medicine]]}}
* [[Moves for Medicine]]


==Related articles ==
==Related articles ==

Latest revision as of 17:28, 2021 August 3

A bed borrow is when a patient is located in one place (e.g. a boarding location, Boarding Loc) while admitted under the physician of a different location (the home location).

Over time we have had various incarnations of collecting this data, this page is an aggregator for the info, and specific collection info for old projects lives on the respective pages.

Currently collected concepts

Legacy concepts

The following concepts were collected separately before Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry:

Background

The concept is important because it affects the Previous Location field, Service/Location field, Dispo field, various cross-checks, and concepts like EMIP, Boarding Loc, Definition of a Critical Care Laptop Admission and Definition of a Medicine Laptop Admission.

Circumstances leading to bed borrows

Examples of circumstances leading to bed borrows are:

  • Own ward to own ER under ICU the care of ICU Service Physicians, then move to ICU, when bed available (Grace-started end of March 2019)
  • ER borrows a ICU bed to do hemodialysis and then the pt goes back to ER.
  • medicine borrows a ICU bed for central line insertion or for dialysis or for a bronchoscopy, etc.
  • post angio monitoring because pre and post procedure in angio is closed in late evening and night shifts.
  • medicine borrows a ICU bed for Cardioversion

Considerations

Bed-borrowing in other locations has always occurred but appear to becoming more common.

Implication: mis-estimation of workload

Our decision to code borrowed beds according to their attending rather than to their physical location means we will underestimate work load in some places and overestimate it in others. There is no way to not have this problem in one direction or the other, so we decided on this one.

Legacy concepts, or considered but never implemented

Related articles

Related articles: