Bed borrow: Difference between revisions
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== 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]], [[ | The concept is important because it affects the [[Previous Location field]], [[Service/Location field]], [[Dispo field]], various cross-checks, and concepts like [[EMIP]], [[Off ward]], [[Definition of an ICU admission]] and [[Definition of a Medicine Service admission]]. | ||
Some procedures like [[Cardioversion]] or hemodialysis can happen in a bed borrow situation. | Some procedures like [[Cardioversion]] or hemodialysis can happen in a bed borrow situation. | ||
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According to [[HSC_Critical_Care_Collection_Guide#STB_CCU_transfers]] a bed there is sometimes borrowed before a pt is sent on to [[HSC CCU]]. Is that still true? Do we ever collect that pt while at [[STB_ACCU]]? | According to [[HSC_Critical_Care_Collection_Guide#STB_CCU_transfers]] a bed there is sometimes borrowed before a pt is sent on to [[HSC CCU]]. Is that still true? Do we ever collect that pt while at [[STB_ACCU]]? | ||
The concept is the counterpart of an [[ | The concept is the counterpart of an [[Off ward]] - a patient who is counted as an OVER by one site would be seen as a bed borrow by the site where they actually are. | ||
=== Circumstances leading to bed borrows === | === Circumstances leading to bed borrows === |
Revision as of 11:30, 2016 November 10
A bed borrow is when a patient is located in one place while admitted under the physician of a different location (the home location).
If a patient overflows into another unit, they are still patient of the unit where they are admitted and in the location on the laptop. Return to the unit is not a transfer. So:
- If a patient comes from arrives on your ward from a bed borrow location, code Pre-admit Inpatient Institution field/Previous Location field as the home location, not the bed borrow one.
- If a patient you collect is currently in a borrowed bed somewhere off-ward, collect the Service/Location field as the home ward.
- If you discharge a patient to a bed borrow location, code Dispo field as the home location.
Exception: EMIP
EMIP patients are essentially bed borrows in the Emergency Room. However, the main users of our data are specifically interested in EMIP patients, so unlike other bed borrows we collect information about them specifically. Enter patients in EMIP locations on our list as EMIP, do not follow following the bed borrow instructions for these.
Background
The concept is important because it affects the Previous Location field, Service/Location field, Dispo field, various cross-checks, and concepts like EMIP, Off ward, Definition of an ICU admission and Definition of a Medicine Service admission.
Some procedures like Cardioversion or hemodialysis can happen in a bed borrow situation.
Template:Discussion According to HSC_Critical_Care_Collection_Guide#STB_CCU_transfers a bed there is sometimes borrowed before a pt is sent on to HSC CCU. Is that still true? Do we ever collect that pt while at STB_ACCU?
The concept is the counterpart of an Off ward - a patient who is counted as an OVER by one site would be seen as a bed borrow by the site where they actually are.
Circumstances leading to bed borrows
Examples of circumstances leading to bed borrows are:
- 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
- (does anyone have additional bed borrow scenerios?)
- (any examples for borrowed med beds?)
Considerations
Apparently the bed-borrow practice is getting more and more common. By not collecting these patients we not accounting for ICU nursing work load caused by them.
In the meantime, our definition of ICU patient stands and excludes bed borrows.
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.
LOS is generally 2-4hrs then they go back to there original department bed.