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 under the Medicine or ICU service.
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.
- 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 all locations there is a specific entry listed in the dropdown (eg ER)
- item: the actual ward, e.g. STB_B5 or HSC_MICU
- For new ward changes, please notify Julie, Tina and update the wiki when this occurs. Tina can then add the new location to the dropdown, Julie will note this for her reports. eg. during the various COVID waves, many surgical wards were used for medicine overflow or COVID patients, if the ward is not available in the dropdown, please notify Tina and Julie.
- comment: leave what is automatically added; the main office doesn't use this part for anything for home locations, but it can be used to crosscheck accuracy.
- no location entered is the default (that entry will not be allowed in a complete record)
- No two different boarding locations should have same start_dt and start_tm.
Template:First Service and Boarding Loc same
Exception
- when a patient is transferred to one of our units, ideally the first service and first boarding Loc should be the same date and time. However, often they are not. In these cases, always use the first service entry line as the date and time for first service and first boarding Loc (make a note in the notes field to change to the first Boarding Loc date and time at a later date when reviewing the chart)
- example- patient transfers from ICU to medical unit. first medicine service=May10@1400, First boarding loc=May10@1630. While the correct first service and first Boarding Loc should be May 10@1630, enter the first service date and time from COGNOS (May 10@1400) for both the first service and first boarding Loc. There are two reasons for this: if you change the first service date and time without excluding that service it will fill up your CSS and you will not get the associated service end date and time. If you exclude that service entry all together than you will also not get the associated service end date and time.
Combining Transfer Ready DtTm tmp entry and Boarding Loc records
- There needs to be one Transfer Ready DtTm tmp entry for each Boarding Loc and vice versa. To mark which entries belong together, use the same integer number in the "combiner" field in Patient Viewer Tab Cognos ADT2 for both records and in sequential order according to Boarding start_dt and start_tm. The presence of matching records is validated by query s_tmp_check_combined_Boarding_Loc_and_TransferReadyDtTm, and their sequential status by query s_tmp_check_combined_BL_and_TRDtTm_nonsequential.
- the integer number should be entered at the time that the paired Boarding Loc and Transfer Ready DtTm tmp entry are entered, as Julie uses this data early to report on
GRA MICU
- Grace ICU boarding in ER choose Boarding Location GH-Emergency
- Grace Main ICU choose Boarding Location and GH-Intensive Care
- Grace Recovery Room (ICU) choose Boarding Location and GH-Recovery Room and enter comment Covid+ICU
- For External(SDC/NFA) ICU beds choose Boarding Loc and GH-External ICU and enter exact location in comments
Special Case - cross-program boarding
If a patient is accepted by your service, taken care of but remains at a location of a different service where we collect for some time before moving to your service, you need to enter a Boarding Loc entry for that period. That originating and different service location becomes the first Boarding loc.
For medicine pts boarding in ICU you can use the explicit ICU entry that applies because all CC locations are explicitly included in Boarding Loc.
For CC patients boarding on a Med ward where we collect, enter "GRA_Med"/"HSC_Med"/"STB_Med" as applicable. We added these boarding loc options specifically for this scenario, and they are available only on CC laptops.
| Example: |
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" "<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. |
Special Case- temporary boarding locations
Occasionally a patient may be transferred to a location that is normally a Boarding Loc that we would enter or discharge to, however that location may be used as a temporary boarding location for a procedure. If after reading through the chart this is in fact the case, that Boarding Loc should not be entered in the TMP, as it should be regarded as though the patient were going for any procedure and then back to their home ward location.
- Sometimes Visits to temporary locations may look like boarding locations. See that page for info on making the distinction.
eg. Medicine patient is transferred to ICMS for a scope and is not admitted under critical care, that Boarding Loc for ICMS should not be entered in the TMP
Special Case - Erroneous Unit information in Cognos EPR Report
Use what you know to be correct from chart and your knowledge of your hospital.
parked in ER
For further information please see
sources for Boarding Loc DtTm
Sometimes the times are not when people really show up at a boarding loctation.
Cognos Unit Listing
Usually the Cognos Unit start time can be used as Boarding Loc.
First set of vital signs
The first set of vital signs is used as Boarding Loc dttm for arrival on the unit in ICU collection, if it is different from the Cognos Unit Start DtTm.
Start/End Dates
- CC Start: 2018-July-19 as Project Borrow arrive and has been renamed and continued as Boarding Loc starting 2019-Sep-01
- Med Start: 2019-Sep-01: new admissions on and after this date.
- 2020-12-16: Change of GRA location names from "our" names to EPR/Cognos names
- 2022-01-01: Change of remaining location names from "our" names to EPR/Cognos names
- End: there is no planned end date
Data Integrity Checks (automatic list)
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.
- Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time
The SAS program is saved in S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas.
- the specific macros are %BoardingLoc, %ACCUBorrow, %ICUOtherService
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)