Bed borrow

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Revision as of 11:59, 2020 January 31 by Ttenbergen (talk | contribs)
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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

Exception: EMIP

is this about to change with Boarding Loc?

  • SMW


  • Cargo


  • Categories

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.

Parked in ER

is this about to change with Boarding Loc?

  • SMW


  • Cargo


  • Categories

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

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.

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
  • (does anyone have additional bed borrow scenerios?)
  • (any examples for borrowed med beds?)
    • These are not situations we can code and these are not units we code in our database eg. ER. If someone wants this data we are unable to code it now without changes to the database. --LBilesky 11:27, 2018 November 5 (CST)

Considerations

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

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

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