DC Treatment

The DC Treatment field (discontinuation of treatment or DC TX) should be coded in the Critical Care program only if life-support treatment is terminated. The field is on the "Reg & ADL & Var" tab on the Patient Viewer in CCMDB.mdb.

DC TX & Transfer Ready Date/time

• If the unit physician discontinues life-support treatment (withdraws therapy) on a patient and death is immediate, then Transfer ready should be left blank. This field is not for recording the date and time when discontinuation of life support process started.
  • is this true even if the transfer ready date was entered much sooner, e.g. a patient was transfer ready and deteriorated several days later? Isn't what we really want just to say the second part: do not use the transfer ready date to indicate dc tx time? Ttenbergen 09:47, 2013 July 4 (CDT) Template:Discussion

Pts who become ACPC and expire in hospital 3 days to one month after comfort care is ordered.

• I would like to know where this type of patients fits in. Example: a patient who has co- morbids and is admitted with pneumonia and does not improve or deteriorates. The decision is made to provide comfort care only (ACPC). This patient lives three days to one month in hospital and then dies. Does this patient need a transfer ready date?
  • I currently code pts who become ACPC and then die within 48 hours as D/C treatment and do not fill out the transfer ready space. If the patient lives longer than 48 hours I will code the patient as Palliative Care and fill the transfer ready space when the order of ACPC is written. Many of my admitted pts come to the hospital to die and I'm not sure if these patients fit into the transfer/overstay predictor project. Please let me know how you code these cases.Judy Kublick 11:32, 2012 September 24 (CDT)~~

• If a unit physician discontinues life-support treatment and a patient does not die immediately and is placed on a transfer/ready list, and then passes away PRIOR TO being transferred out of the ICU unit, then Transfer ready should not be recorded.

• If a patient arrests in the unit and CPR is unsuccessful, the date and time of stopping CPR should not be recorded for Transfer ready.

Legacy Information

This field was also collected in Medicine until 2013-07-04. Collection stopped because the distinction is not clear enough for coding on a medicine ward.

confusion

Shirley added the following to an old version of the article so I reverted to the newest version and am adding the comment here:

• This D/C treatment is now more confusing than ever?Trish do you want us to code D/C pt on a medicine ward or is it just for critical care? Please clarify Thanks shirley 13:37, 2013 July 4 (CDT) Template:Discussion
  • We discontinue treatment on patients all the time on Medicine. Vital signs are no longer taken, all meds are stopped except for maybe scopalamine & morphine for comfort measures, no bloodwork is drawn, death is imminent. Why can we not have/use D/C TX? It does not only happen in ICU.--CMarks 12:58, 2013 July 31 (CDT)