Boarding Loc: Difference between revisions

From CCMDB Wiki
Jump to navigation Jump to search
(You are right, the CAU info was leftovers from when these were first started and owned by ER.)
Line 53: Line 53:
=== Special Case - EMIP/ECIP ===
=== Special Case - EMIP/ECIP ===
See [[2020-10 EMIP changes]]
See [[2020-10 EMIP changes]]
=== Special Case - CAU ===
{{Guideline CAU vs Boarding Loc vs EMIP}}
{{Discuss|If the patient ends up moving to a ward from CAU, why would we treat the CAU as a boarding loc?  We don’t collect data on CAU patients so wouldn’t it be a new profile? I know at one time the CAU was considered an extension of the ER, but I believe that may have changed now, as I believe all of the CAU’s are located away from the ER’s and are considered an inpatient location, under family medicine service. e.g at HSC the CAU is now located on WRS3, At Grace it is located in the old ER and are under a grace HMO. At SBGH I think CAU is located on 6AS.  I will double check with our admitting girls.  If it is an inpatient location then this would not be an EMIP.  After checking with admitting, CAU is considered an inpatient location.  If we were to treat all admissions to CAU as an EMIP we would have quite a few, that is not our current practice (ie. we do not enter CAU patients as EMIP'S), we do not follow CAU patients. 
*I can only speak to what I've seen at the Grace - it seems our CAU is intended to be a brief stay. Like they need a little more time/care than can be given in ER, but won't need a prolonged admission. If after a couple days the patient isn't improving and will need to be admitted they'll be taken over by medicine and get admitted to the ward. We've never treated CAU as a boarding loc, and my understanding the only Accept Time that we enter (and track) is the ER to ward times. [[User:Surbanski|Surbanski]] 08:19, 2020 October 16 (CDT)}}


=== Special Case - COVID ===
=== Special Case - COVID ===

Revision as of 23:46, 2020 October 18

Projects
Active?: active
Program: CC and Med
Requestor: internal
Collection start: 2019-Sep-20
Collection end:

This isn't so much a project as way to track how patients physically move around the hospital. See Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry for information about it and why we needed to change it to this model.

This project tracks where and when a patient arrives into a new physical location.

Data Collection Instructions

In TMP, a "no borrow" entry will automatically be added to every new Critical Care or Medicine patient's record.

If the patient never ends up in a "borrowed bed" during their stay then, leave the default in Item as no borrow and also put a check mark in the checkbox. (this is to verify that there was no bed borrow, otherwise no one is sure is missed or not). If the patient does end up in a "borrowed bed", change the item to the location of the borrow and enter the rest as per below: #How to enter this.

Add a new tmp entry for every additional move/borrow within your centre that a patient makes during their stay at your Service/Location; including moves from borrowed location to your actual unit.

How to enter this

  • Use tmp fields:
    • Project: Boarding Loc
    • Enter start_dt: arrival date at physical location, under column E.
    • Enter start_tm: arrival time at physical location, under column M.
    • checkbox: not used for this project
    • Item: no location entered is the default (that entry will not be allowed in a complete record)
      • change the original entry to the first location the patient was during the admission in this record, e.g. ER, specific medicine ward etc
      • for any physical move to another unit, enter an additional Boarding Loc entry:
        • For "home" locations
          • item: the actual ward
          • comment: leave blank
        • For "boarding" locations
          • item: "<your site> - boarding" (eg. HSC - boarding)
          • comment: leave blank

{{DT |

  • inactivate legacy entry Home Medicine ward once last pt using it is discharged

}

APACHE

The APACHE elements time frame will start in the off-ward bed location.

  • Does it really start in ER? since that's now one off-ward location? In any case, we should really only link to the definition in APACHE from here so this doesn't become inconsistent. If someone knows where that's documented, can you please confirm and fix? Ttenbergen 00:36, 2020 October 16 (CDT)
  • SMW


  • Cargo


  • Categories

TISS

TISS starts from the off-ward bed.

  • This would now mean TISS starts in ER if the pt is in ER long enough. We discussed that a while ago and I can't remember the outcome. This might need to be updated to correspond to that. Or rather, this should only be a link to that so it doesn't go inconsistent in the future. If some one knows what was decided, can you please fix this? Ttenbergen 00:36, 2020 October 16 (CDT)
  • SMW


  • Cargo


  • Categories

Special Case - Parked

  • For patients who are Parked in ER, just follow usual instructions, a special entry is no longer needed, since the ER delay will take care of them.

Special Case - EMIP/ECIP

See 2020-10 EMIP changes

Special Case - COVID

See 2020-10 COVID unit collection.

earlier info   

During the COVID-19 pandemic there were a lot of movements of entire wards (see Category:2020 COVID unit transition for related pages). The Boarding Loc project was a convenient place to store this information, so we added some specific locations for this purpose:

  • HSC_D4_P
  • HSC_D5
  • HSC_D5_p
  • HSC_H4H
  • STB_E6_B
  • GRA_5N

Start/End Dates

  • Start: 2019-Sep-01: new admissions on and after this date.
  • End: there is no planned end date

Loose ends

  • we have two entries "GRA_ER" and "GRA - ER". The "- ER" one is same format as the STB and HSC ones. We should probably consolidate the GRA_ER entry into GRA - ER. For now, collectors please use "GRA - ER", and when the last "GRA_ER" is gone I will get rid of the option and we can consolidate them. Ttenbergen 19:26, 2020 October 15 (CDT)
    • we have two 5N entries as well: GRA - N5 and GRA_5N. As previously discussed we've been using GRA - N5 but let us know if that changes Surbanski 08:23, 2020 October 16 (CDT)
      • Please use GRA - N5 as you have been. If neither of you has an GRA_5N on your laptop now I can inactivate that one. Ttenbergen 08:26, 2020 October 16 (CDT)
        • I can confirm that our Boarding Loc entries are GRA - N5 and GRA - ER. You can remove the duplicates for both. Surbanski 08:49, 2020 October 16 (CDT)
  • SMW


  • Cargo


  • Categories


  • SMW


  • Cargo


  • Categories

Which if any of Project_Borrow_arrive#Data_Integrity_Checks_.28SMW.29 will need to be moved over to this instead?

  • SMW


  • Cargo


  • Categories

Data Integrity Checks (automatic list)

 AppStatus
Query check tmp ER Boarding Loc should exist if from ERCCMDB.accdbdeclined
Check if awaiting code is primary dx then Transfer Ready DtTm must be equal to Arrive DtTmCCMDB.accdbdeclined
Query s tmp check Boarding Loc and TransferReadyDtTm pairsCCMDB.accdbimplemented
Query check tmp 2 BL TR S same tmCCMDB.accdbimplemented
Query Check BL TR combiner nullCCMDB.accdbimplemented
Query check Transfer DtTm after paired BL and before later BLCCMDB.accdbimplemented
Query s tmp Boarding Loc ER delay reasonableCCMDB.accdbimplemented
Query check no consecutive same BL or ServiceCCMDB.accdbimplemented
Query check CCI TISS matching BoardingLoc timeCCMDB.accdbimplemented
Query check tmp Boarding Loc Service first sameCCMDB.accdbimplemented
Query s tmp check combined Boarding Loc and TransferReadyDtTmCCMDB.accdbimplemented
Query check transfer DtTm during admissionCCMDB.accdbimplemented
Query check tmp Service and Boarding Loc during admission timeframeCCMDB.accdbimplemented
Query check tmp service or location duplicateCCMDB.accdbimplemented
Query s tmp Boarding Loc date itemCCMDB.accdbimplemented
Query check minimal data set incompleteCCMDB.accdbimplemented
Query check tmp Transfer Ready not before Boarding LocCCMDB.accdbretired
Query s tmp check combined BL and TRDtTm nonsequentialCCMDB.accdbretired
Query check transfer ready tmp for each Boarding LocCCMDB.accdbretired
Query s tmp Boarding Loc no borrow but entryCCMDB.accdbretired

Data Use

Critical care and Medicine programs want to know this to better understand patient flow and bed utilization.

SAS Program

The SAS program calculates the time spent in a borrowed bed at each ICU stay and summarize the total bed-days in a given interval that are taken up by boarders from elsewhere and how much a certain unit is boarding elsewhere.

Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time
where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time.

The SAS program is saved in X:\Julie\SAS_CFE\CFE_macros\Bed_Borrow.sas

Background

See Bed borrow as aggregator page for other boarding and borrow related concepts.

The concept is similar to EMIPs but we will keep the EMIP separate from this project. The current EMIP will stay the same.--JMojica 10:37, 2019 September 20 (CDT)

Related articles

Related articles:
Retrieved from "https://ccmdb.kuality.ca/index.php?title=Boarding_Loc&oldid=146584"