Boarding Loc

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

How to enter this

You can use the "Make loc" button to generate and pre-populate these entries.

• 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.

The first entry for Boarding Loc and for Service tmp entry need to have the same date and time because we only care about the portion of time in that earliest location that was under our service. So, e.g. if in ER the pt is accepted initially by surgery we don't care about the unit start date and time until our service takes over. Flagging this: if we don't enter the actual unit start dttm (ie might be before service start) then these won't line up with Cognos data, so will not proberly show up as having been entered. I think the actual unit start should be used and any stripping out of times is a matter of reporting. The corresponding entry in Service tmp entry will need to be updated accordingly. Ttenbergen 13:21, 2020 November 9 (CST) why do we need to collect information which are not directly related to CC or Int Med patients? regardless where we save the data, we should be consistent. that is how we crosscheck errors (whether it is time,location, diagnosis, procedures). Is this a common situation or rare? if rare, then let it be an exception with Cognos data (e.g. not line up). if common, let us discuss in Task. --JMojica 15:08, 2020 November 9 (CST)

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• Cargo

• Categories

• • 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, e.g. STB_B5 or HSC_MICU
      • comment: leave blank
    • for "boarding" and COVID Suspect locations
      • item: "<your site> - boarding" (eg. "HSC - boarding", resp. "HSC - ICU boarding")
      • comment: actual unit
    • for COVID Positive locations
      • item: "<your site> - COVID unit" (eg. "GRA - COVID unit")
      • comment: actual unit

Special Case - cross-program boarding

If a patient is accepted by your service but remains at a location of a different service for some time before moving to your service, you need to enter a Boarding Loc entry for that period.

For Critical Care collection, this could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med" (ie GRA_Med, HSC_Med, STB_Med) for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are. The generic "<Site>_Med" entry would only be available on CC laptops.

For Medicine laptops this isn't an issue because all CC locations are explicitly included in Boarding Loc.

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

• For details of which patients to inlcude, see 2020-10 COVID unit collection.
• For units with special designation see COVID Designated Ward

Special Case - COVID status of unit changes while patient location and service remains same

• If the unit a patient is on changes to be a COVID Designated Ward, or changes to no longer be a COVID unit, and the patient stays put and remains on your service.
  • If the unit a patient is on changes to be a COVID unit, enter a Boarding Loc entry of <your site> - COVID unit (e.g. "STB - COVID unit") for any admission to and time spent in a COVID unit
    • enter the actual location into the comment field, e.g. E6
  • If the unit a patient is on changes to no longer be a COVID unit, and the patient stays put, enter a Boarding Loc entry of the Service/Location, e.g. STB_E6_B

Special Case - Erroneous Unit information in Cognos EPR Report

Sometimes there are location entries in Cognos that are errors. EG. a patient may be listed as having gone to a weird unit for 5 minutes and then moved to a more reasonable one. They were probably never on that weird unit. For those cases, just exclude the location from your list so it doesn't clutter things, and don't enter this as a location.

To confirm: Julie, this means that if a pt was listed in Congos as some bogus unit for the first 6 hours of their stay, we would list their stay on our unit as starting 6 hours later. this would probably trigger some of Pagasa's cross checks, and give you 6 hours of missing occupancy. I still think it's the right way to deal with this error since messing with the times would break how entries are linked to Cognos, but I want to make sure we are all aware that this is a thing and how we approach it. Ttenbergen 13:29, 2020 November 9 (CST) when does this phenomenon occur - at the beginning or in between transfers? if at the beginning, then just exclude. If in between transfers during an episode, is there a query done for that? Pagasa' query will crosschecks between records and not within episode. But if that happens, since only the arrived date is entered, I will always assume continuous stay defining the end date as the start date of the next boarding location.

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• Cargo

• Categories

Start/End Dates

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

Loose ends

Query ''check ER Delay not too big'' needs to be changed to include the new Boarding Loc schema .

• 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

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

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Data Integrity Checks (automatic list)

	App	Status
Query check tmp ER Boarding Loc should exist if from ER	CCMDB.accdb	declined
Check if awaiting code is primary dx then Transfer Ready DtTm must be equal to Arrive DtTm	CCMDB.accdb	declined
Query s tmp check Boarding Loc and TransferReadyDtTm pairs	CCMDB.accdb	implemented
Query check tmp 2 BL TR S same tm	CCMDB.accdb	implemented
Query Check BL TR combiner null	CCMDB.accdb	implemented
Query check Transfer DtTm after paired BL and before later BL	CCMDB.accdb	implemented
Query s tmp Boarding Loc ER delay reasonable	CCMDB.accdb	implemented
Query check no consecutive same BL or Service	CCMDB.accdb	implemented
Query check CCI TISS matching BoardingLoc time	CCMDB.accdb	implemented
Query check tmp Boarding Loc Service first same	CCMDB.accdb	implemented
Query s tmp check combined Boarding Loc and TransferReadyDtTm	CCMDB.accdb	implemented
Query check transfer DtTm during admission	CCMDB.accdb	implemented
Query check tmp Service and Boarding Loc during admission timeframe	CCMDB.accdb	implemented
Query check tmp service or location duplicate	CCMDB.accdb	implemented
Query s tmp Boarding Loc date item	CCMDB.accdb	implemented
Query check minimal data set incomplete	CCMDB.accdb	implemented
Query check tmp Transfer Ready not before Boarding Loc	CCMDB.accdb	retired
Query s tmp check combined BL and TRDtTm nonsequential	CCMDB.accdb	retired
Query check transfer ready tmp for each Boarding Loc	CCMDB.accdb	retired
Query s tmp Boarding Loc no borrow but entry	CCMDB.accdb	retired

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)

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