|Data Element (edit)|
|Table:||L Log table|
|Program:||Med and CC|
The Dispo field contains information about what happens to the patient at the end of their admission.
Legacy implementation right in the table
- see Visits to temporary locations for dispo to temporary locations, ie. OR, dialysis, procedure suites of all types, imaging suites/radiology
Enter "AMA (left against medical advice)" for patients who leave against medical advice (type "AMA" to open up drop down).
AMA is used as follows:
- AMA is being excluded in the calculation of Readmission rate.
- AMA is being counted as HOME in reporting for the location the patient went after discharge.
- AMA as itself for specific request.
AMA should be entered whether the patient follows the WRHA AMA process (signing form etc) or just goes AWOL. This will lead to proper reporting for the first two points, and it will allow a chart review to exclude AWOL person depending on the data requirements in the third case.
The Dispo DtTm field is when the person left AMA, or was noted to be gone and assumed AMA. If a bed is "held" and the patient indeed returns, goes back into that bed without being readmitted (because the bed was held), then this isn't to be considered to be an AMA. This follows the same kind of reasoning as Visits to temporary locations.
If a homeless patient is discharged, either to a place like Siloam Mission or even without a specific plan, then code them as discharged to home. Consider whether they might have left AMA.
If a patient is discharged to prison, jail or a correctional institution, code this as a Institution NOS.
- Pre acute living situation field should be coded as: Jail/correctional institution.
Discharged to ER or Urgent Care
If you discharge a patient to the ER or Urgent Care, you can't enter this in the dispo field. The reason is that this should not happen. If it really does happen:
- enter Other Continents - unknown/other (this is a very rare entry so when we see it, we can question it. Put a note in to the Notes field so Pagasa can check there first.)
- email Pagasa so she can enter your ER / Urgent Care location as dispo.
We don't want ER to be available in the dropdown because it had been mistakenly entered a number of times. If it turns out there are a lot of legitimate discharges to ER we will make the option available.
- Deceased patients#General instructions for deceased patients
- Guideline for coding organ donation after death
- Visits to temporary locations
"Can we remove the items that are no longer Service/Locations, Previous Locations, Pre-admit Inpatient Institutions or dispo locations from the dropdowns?"
We can and will remove them, but that can only happen once no more laptops use them. We will need to keep track of this and then remove them when ready. If I removed them now, then any box that currently has them enter would misbehave.
query of what is currently available
SELECT s_dispo.location_name, s_dispo.Site, s_dispo.active, s_dispo.inpatient, s_dispo.previous_location, s_dispo.s_location, s_dispo.dispo FROM s_dispo WHERE (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.inpatient)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.previous_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.s_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.dispo)=True));
Query of what is currently used
- Unit Mortality
- Intra or Inter Transfer Rate
- Discharges out of hospital
- Organ donor rate
- AMA Rate
- Linking admissions
Data Integrity Checks (automatic list)
|Check pre acute consistent||CCMDB.accdb||declined|
|Function Validate Dispo||CCMDB.accdb||implemented|
|Check function location NE dispo||CCMDB.accdb||implemented|
|Query check ICD10 dx implying death must have appropriate dispo||CCMDB.accdb||implemented|
|Query check dispo lower acuity than location||CCMDB.accdb||retired|
|Link suspect dead then alive query||Centralized data front end.accdb||implemented|
|Link suspect mismatch to ours incomplete query||Centralized data front end.accdb||implemented|
|Link suspect not same visitAdmitDtTm query||Centralized data front end.accdb||implemented|
The field is populated with options from the s dispo table.
It a combination of our previous
Data from these fields has been back-populated to the this field so data is available from the beginning of the database.
Very early missing Discharge-tos
There were 6762 very old ICU records who are listed as survived but didn’t have a discharge-to. This is from HSC-only days when there simply were no checks.