Dispo field: Difference between revisions

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{{Data_element
{{Data element
| field_name = dispo
| CCMDB_tab = Dispo
| CCMDB_label = Dispo
|field_name=dispo
| element_description = The Dispo field contains information about what happens to the patient at the end of their admission.
|CCMDB_label=Dispo
| in_table = L_Log
|Rank=Dispo
| data_type = integer
|in_table=L Log table
| datafield_length = long  
|data_type=number
| program_collecting = Med and CC
|datafield_length=long
| created_raw = Raw
|program_collecting=Med and CC
| data_element_start_date = 2016-07-01
|created_raw=Raw
| data_element_sort_index = 41
|data_element_start_date=2016-07-01
|data_element_sort_index=41
|element_description=The Dispo field contains information about what happens to the patient at the end of their admission.
}}
}}


== Collection Instruction ==
== Collection Instruction ==
If you know the location exactly, you can type it. Otherwise press the "?" button to take you to the [[S dispo chooser‎]] to help filter options if desired.
=== surviving patients ===
* Enter:
{{PrePrevDispo listing}}


=== surviving patients ===
* see [[Visits to temporary locations]] for dispo to temporary locations, ie. OR, dialysis, procedure suites of all types, imaging suites/radiology
For each patient,
 
* enter the location that most closely matches
==== [[HSC Stepdown Units]] ====
** for wards where we don't collect, enter e.g. HSC_ward
** for wards where we do collect enter the actual ward as available in the dropdown
* consider [[bed borrow]]s


==== [[AMA]] ====
==== [[AMA]] ====
* for patients who leave against medical advice, enter "AMA (left against medical advice)" (type "AMA" to open up drop down where you want it)
* {{discussion}} There was a discussion whether this should be used only for medically competent patients who follow the WRHA process an sign out as AMA, or also for patients who just up and leave. How do collectors code this? How does Julie use this?  Ttenbergen 10:03, 2017 September 7 (CDT)
** If the chart indicates that the patient left AMA then I document this as such, I do not check to see if the patient was medically competent or if the WRHA process was adhered to. Generally, if there is some question as to the competency of the patient as it pertains to decision making, there is documentation in the chart, and often consults to psychiatry to assess this [[User:Lkaita|Lisa Kaita]] 11:18, 2017 September 7 (CDT)
**I agree with Lisa.  If there is a competency issue, psych is consulted and if they feel the pt cannot make the decision and they are not medically stable, they will keep them in under a legal form that is completed to cover this. --[[User:LKolesar|LKolesar]] 12:06, 2017 September 7 (CDT)
*** That would address patients who end up '''not''' leaving, so those should not be a matter of collecting as AMA. AMA in Dispo field is only about patients who do manage to leave, right? So even if held under a some sort of form, if they get away, they get away. Should "those who got away" be coded as AMA even if they should not have got away, and didn't follow the process? Ttenbergen 10:54, 2017 September 11 (CDT)


==== [[Homeless]] patients ====
==== [[Homeless]] patients ====
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==== [[Prison / Jail / Correctional Institution]] ====
==== [[Prison / Jail / Correctional Institution]] ====
If a patient is discharged to prison, jail or a correctional institution, code this as a discharge to home.  
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.


==== [[Parked in ER]] ====
===[[Chronic Health Facility]] ===
==== [[Operating room visits]] ====
{{PCH Riverview Deer Lodge}}


=== deceased patients ===
==== Discharged to ER or [[Urgent Care]] ====
* for patients who expire, one of
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:
** "Died - [[Organ_Donor]]" (follow definitions in that article)
* enter '''Not Canada or USA - 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.)
** "Died - NOT Organ Donor"
* email Pagasa so she can enter your ER / Urgent Care location as dispo.
[[Category:End-of-life related data]]
 
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.
 
==== [[Visits to temporary locations]] ====
See [[Visits to temporary locations]]
 
=== [[Deceased patients]] ===
See
* [[Deceased patients#General instructions for deceased patients]]
* [[Guideline for coding organ donation after death]]
* [[Visits to temporary locations]]
 
{{Location dropdown cleanup}}


== Data Use ==
== Data Use ==
* Mortality Rate
* [[Unit Mortality]]
* Intra or Inter Transfer Rate
* Intra or Inter Transfer Rate
* Discharges out of hospital
* Discharges out of hospital
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* Linking admissions
* Linking admissions


== {{CCMDB Data Integrity Checks}} ==
== Cross checks ==
* cannot use: not applicable
{{Data Integrity Check List}}
* location_NE_dispo() - [[Service/Location field]] can't be same as [[Dispo field]]


Following might still need to be implemented:
== Implementation ==
* [[Check organ donors must be dead]] - this is a dx cross check - can it wait for ICD10? {{ICD10}} Actually, I don't think this dx will be available in ICD10, since it's not a diagnosis. So, likely it will only be coded in dispo field once ICD10 is in place, at which point this comment could go. Ttenbergen 09:56, 2016 June 16 (CDT)
The field is populated with options from the [[s dispo table]].


== Implementation ==
== Related Articles ==
The field is populated with options from the [[s_dispo table]].
{{Related Articles}}


== Legacy ==
== Legacy ==
This field is part of the [[2016 Time and Place changes]].
This field is part of the [[2016 Time and Place changes]] and was affected by the [[PatientFollow_Project]].


It a combination of our previous  
It a combination of our previous  
* [[Admit From & Discharged To | Discharge To]]
* [[Admit From & Discharged To|Discharge To]]
* [[Var 2 - Discharge-to Ward]]
* [[Var 2 - Discharge-to Ward]]
* [[ICU Var 6 - AMA]]
* [[ICU Var 6 - AMA]]
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When data was brought across from the old [[discharge to]] field the [[dispo]] fields of these records were set to 'survive(Legacy)'.  
When data was brought across from the old [[discharge to]] field the [[dispo]] fields of these records were set to 'survive(Legacy)'.  


[[Category: 2016 Time and Place changes]]
[[Category:2016 Time and Place changes]]
[[Category: Admit/Discharge]]
[[Category:Admit/Discharge]]
[[Category: Registry Data]]
[[Category:Registry Data]]
[[Category: L Log]]
[[Category:Dispo]]
[[Category:Data Collection Guide]]

Latest revision as of 10:56, 2023 December 13

Data Element (edit)
Field Name: dispo
CCMDB Label: Dispo
CCMDB tab: Dispo
Table: L Log table
Data type: number
Length: long
Program: Med and CC
Created/Raw: Raw
Start Date: 2016-07-01
End Date: 2300-01-01
Sort Index: 41

The Dispo field contains information about what happens to the patient at the end of their admission.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


Collection Instruction

surviving patients

HSC Stepdown Units

AMA

Homeless patients

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.

Prison / Jail / Correctional Institution

If a patient is discharged to prison, jail or a correctional institution, code this as a Institution NOS.

Chronic Health Facility

If a patient is discharged to a PCH bed at Deer Lodge or Riverview, then the option "Winnipeg PCH" should be used in the Dispo field.

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 Not Canada or USA - 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.

Visits to temporary locations

See Visits to temporary locations

Deceased patients

See

"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

SQL    
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

query z_s_dispo_inactivatable

Data Use

  • Unit Mortality
  • Intra or Inter Transfer Rate
  • Discharges out of hospital
  • Organ donor rate
  • AMA Rate
  • Linking admissions

Cross checks

Data Integrity Checks (automatic list)

 AppStatus
Check pre acute consistentCCMDB.accdbdeclined
Function Validate DispoCCMDB.accdbimplemented
Check function location NE dispoCCMDB.accdbimplemented
Query check ICD10 dx implying death must have appropriate dispoCCMDB.accdbimplemented
Query check dispo lower acuity than locationCCMDB.accdbretired
Link suspect dead then alive queryCentralized data front end.accdbimplemented
Link suspect mismatch to ours incomplete queryCentralized data front end.accdbimplemented
Link suspect not same visitAdmitDtTm queryCentralized data front end.accdbimplemented
Query cardiac arrest throughout admissionCentralized data front end.accdbneeds review

Implementation

The field is populated with options from the s dispo table.

Related Articles

Related articles:

Legacy

This field is part of the 2016 Time and Place changes and was affected by the PatientFollow_Project.

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.

Related articles:

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.

When data was brought across from the old discharge to field the dispo fields of these records were set to 'survive(Legacy)'.

Retrieved from "https://ccmdb.kuality.ca/index.php?title=Dispo_field&oldid=160488"