EMIP

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EMIP stands for Emergency Medicine "IN" patient. It is used for patients who are admitted to our internal medicine service and spend their entire admission under one of the medicine services we follow in the ER (emergency department). We are tracking this as VIC_EMIP, GRA_EMIP, STB_EMIP and HSC_EMIP.

Definition of EMIP

  • Should we now re-define this as "Patient who has a record in EPR/Cognos Report Integrator for a Service we collect while in ER , and who does not then end up on one of the wards/units that correspond with that service, regardless where they go instead." and then turn the specific scenarios into examples rather than keep them part of the definition? I guess it depends on the outcome of the discussions under #Identifying EMIPs and What is a service admission
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  1. Pt has an order or some entry that medicine has accepted the patient while still in ER.
  2. The patient leaves the ER to either
    • home or
    • any other out of hospital location or
    • the patient is transferred within the hospital to any service because Medicine decides that they will not take the pt but the patient needs different care or
    • dies in ER ("ED Death after Arrival" in Cognos)
    • leaves AMA ("ED Reg/Triaged/Assess LAMA" in Cognos)

Patients in ER admitted under other services are not EMIPs

Our definition of EMIP includes only patients that were followed by one of our services. So, patients who were followed by Family Medicine or Trauma while still in the ER are not EMIPs.

Identifying EMIPs

Identifying EMIPs in Cognos Admitter

EMIPs show up in Cognos Admitter. Because they don't have a Unit Arrive DtTm they filter to the end of the list when sorted by date.

If a patient is listed who is still in the ER at the time the list is reviewed (i.e. it isn't clear if they will turn into a fully arrived patient or an EMIP), ...

Identifying patients (old way, in EPR)

EMIPs will show up under:

  • the Transfer Register if they are sent to non-medicine units in your hospital.
  • EMIP's in this list will be those under the medicine or internal medicine service that subsequently changed service before leaving ER and were transferred out of ER to a local hospital ward or unit. (not a medicine ward).
    • see instructions for Off ward field to also identify some EMIP patients. See this under the title "how to identify off-ward patients" in that article.
  • the Discharge Register if they leave the hospital
    • When reviewing the discharge list generated by the instructions, the EMIP's are those that have medicine or internal medicine under the "service" heading.

Discussion about identification process

  • There are emails flying back and forth right now that make it clear that the identification process described here is not the full, true story. Hopefully someone who actually uses the process can fix that. Likely best to wait until after the meeting about this on the afternoon of Oct 22. Ttenbergen 14:52, 2020 October 21 (CDT)
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question that has nothing to do with EMIP but for which I would like an answer Ttenbergen

  • ...with the exception of the ER delay pop up which pops up 4 times, we check the first time but find the remaining 3 reminders slightly overkill...
    • Can you confirm that this is the check Query ''check ER Delay not too big''? If so, then the problem should be gone now, since we can't run that check any more (will need to be replaced with a new check that goes between Boarding Loc entries eventually, but the mechanism that causes multiple errors won't be an issue any longer for those). This is also tracked in Multiple LOS errors. Ttenbergen 22:12, 2020 October 18 (CDT)
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Entering data for EMIPs

Entering patients in dispo tab fields

  • Is that still true that we can't dispo to an ER? Should we be able to? EG if Emergency Medicine takes them back (does that happen?) or they get sent to another site's ER? Why should that not be allowed? Ttenbergen 21:59, 2020 October 18 (CDT)
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Follow the instructions in Boarding Loc, Service tmp entry, Transfer Ready DtTm tmp entry; if you do, none of these special instructions for EMIPs should be required. That's part of the point of going to the new scheme.

Collecting an EMIP who has been transferred to your location

Collection includes patients who are discharged to another service's location in the hospital. (eg Med to CC or CC to Med)

  • That is an interesting point. GRA_Med is not really a location. Julie, if you can confirm that this is how you want these coded, please take out the question, else how should they be coded? And same for ECIPs?
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  • Ditto.
    • see above.
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EMIP scenario

  • In ER under Medicine service and left your hospital to Home or died in ER
  • In ER under Medicine service and transferred to other locations under different service in your hospital
  • In ER under Medicine service and discharged to other locations in another hospital

NOT an EMIP

  • In ER under Medicine service and then moved to a Medicine service ward (i.e. a regular Medicine admission)
  • In ER under Medicine service and then moved to other ward but under Medicine service (i.e. a case of off ward patients).

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