Definition of a Medicine Laptop Admission

From CCMDB Wiki

This page defines what would be a profile in the Medicine portion of the database (see also Definition of a Critical Care Laptop Admission); it is relevant for Using Cognos2 to keep track of patients general data use.

Each Medicine profile constitutes all care in any Internal Medicine location (see Boarding Loc) or Service (see Service tmp entry) at a given hospital with certain exceptions (see #Excluded patients further below in this article). Thus once a patient is admitted to an Internal Medicine service at a given hospital (regardless of where they are physically), a profile begins -- and the same profile includes all continuous direct transfers among Internal Medicine services and locations while under Medicine at that same hospital. For a transfer between hospitals a new database profile is started.

Included patients

  • The following situations ARE included for the Regional Medicine Database.

Inclusion based on service

  • Admitted under a Medicine service attending physician anywhere in the hospital (including, for example, if they are remaining in ED because there is no medicine ward bed yet). (see #excluded patients)
    • includes "HSC Oncology / Medicine"

Inclusion based on location

  • Admitted to a Medicine ward location but rather than being cared for by the regular ward team, the primary care service is
    • Nephrology
    • Neurology (includes "HSC Internal Med / Neurology" patients admitted to HSC HOBS)
    • Oncology -- EXCEPT if admitted ONLY for chemotherapy (if complications occur and Medicine service takes over, admit the pt starting at medicine service acceptance)
  • For this purpose, we INCLUDE Nephro, Neuro or Onc patients who are located on one of the mixed wards (i.e. wards that have both Medicine and non-Medicine [e.g. surgery] beds; an example of such wards are the mixed COVID wards). The rationale is that what we are seeking to capture is patients who use Medicine "resources". So by this criterion, Nephro, Neuro or Onc who are in ED are NOT included in the Medicine database as ED beds are not a Medicine resource.
  • For these inclusions based on location, once pt is transferred out of the Medicine ward location, we no longer follow the patient. (see #excluded patients)

Excluded patients

  • The following situations ARE NOT included for the Regional Medicine Database:
    • Oncology patients admitted only for chemotherapy. These are short stay patients with only nursing IPN entries.
    • Nephrology, Oncology or Neurology patients whose primary care service is (respectively) nephrology, oncology or neurology -- who are NOT on a Medicine ward location.
    • Patients who use a ward bed for a procedure but are NOT admitted to the Medicine service, and indeed these patients are usually not formally inpatients at all. Examples include a patient who is using a ward bed for: insertion of a central line; diagnostic endoscopy; dialysis.
    • Patients admitted to HSC_H6 under "HSC Internal Med / Respiratory" or "HSC Internal Med / Neurology" -- actually this fits into the above rules, as HSC_H6 is not a Medicine ward location.
    • Interventional radiology pts admitted for an overnight procedure (not on Cognos EPR Report so easy to exclude)
    • exclude "HSC Oncology / Radiation"
    • exclude "IV infusion Administration"

End of a database profile

Bed holds

To see when a profile should continue vs new profile, see Bed holds.

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