Dispo field
| Data Element (edit) | |
| Field Name: | dispo |
| CCMDB Label: | Dispo |
| CCMDB tab: | not stated |
| Table: | L_Log |
| Data type: | integer |
| 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.
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
For each patient,
- enter the location that most closely matches
- 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 borrows
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)
- Template: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 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. --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)
- How AMA is used? 1) AMA is being excluded in the calculation of Readmission rate. 2) AMA is being added to HOME for the location the patient went after discharge. 3) AMA as itself for specific request. I think the above issue will only affect item 3 if our AMA definition is a mixed of medically competent or not which will then be a case to case basis depending on the purpose of the requestor. --JMojica 11:24, 2017 September 11 (CDT)
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 discharge to home.
Parked in ER
Operating room visits
deceased patients
- for patients who expire, one of
- "Died - Organ_Donor" (follow definitions in that article)
- "Died - NOT Organ Donor"
Data Use
- Mortality Rate
- Intra or Inter Transfer Rate
- Discharges out of hospital
- Organ donor rate
- AMA Rate
- Linking admissions
Template:CCMDB Data Integrity Checks
- cannot use: not applicable
- location_NE_dispo() - Service/Location field can't be same as Dispo field
Following might still need to be implemented:
- Check organ donors must be dead - this is a dx cross check - can it wait for ICD10? Template: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)
Implementation
The field is populated with options from the s_dispo table.
Legacy
This field is part of the 2016 Time and Place changes.
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)'.