Bed holds

A Bed holds is when a patient goes to another location but the bed is not released. This page defines whether a profile should continue or not during a bed hold.

• We go by Cognos/Electronic Health Record ADT record to determine if there was a bed hold, specifically:
  • If the patient did, at some point, return to hospital A from hospital B, and ADT indicates that the patient was NOT discharged from hospital A during the say in hospital B -- then we consider the entire stay (time in A, then B, then back in A) as a single record in hospital A, including all the CCI Procedures done during the time at hospital B.
  • If the patient did, at some point, return to hospital A from hospital B, and ADT indicates that the patient WAS discharged from hospital A during the time at hospital B -- then we will consider this as TWO profiles in hospital A, with the first one ending when the patient physically left to go to hospital B (i.e. not when ADT shows the patient was discharged from A), and the second one starting when the patient returned to hospital A. In this case, the CCI Procedures that occurred during the time in hospital B are not included in either record for hospital A unless they include an Admit Procedure for the 2nd admission to hospital A.
  • If the patient did NOT return to hospital A from hospital B then there will be an indication in ADT of the discharge from hospital A, and our single hospital A record collected with a BedHeldEnd DtTm

Cross Checks

If bed holds are entered inconsistently between two sites where we collect, then a query in Category:Multiple_Encounter_linking will catch this. If both locations consistently didn't code this correctly, our cross checks would not catch this.

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• Before we had access to hospital admit/discharge/transfer information (available both from COGNOS and EMR), we had to manually deal with the situation where a patient is sent away from the current hospital (A), to a different hospital (B) almost always for specific procedures, with the expectation they will return after the procedure. While this is usually the case, sometimes the patient remains after the procedure for an extended period, and (rarely) gets admitted to hospital B due to complications; but if that admission is to a location where we do not collect data, we have no way of knowing. This is a "bed hold".

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