EMIP

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 Cognos2 Service Starter

EMIPs show up in Cognos2 Service Starter. They can't be identified there as EMIPs, but that's OK, since they really are just like any other patient now and should just be entered.

There has been some discussion whether or not a patient accepted by our service but still in ER when Cognos first lists them should actually be entered then, or only after they either leave from ER or become an inpatient. People have been leaving these un-entered both out of old habit (when EMIPs were entered following different rules you first had to know if a pt would need to be entered as EMIP or as regular) and to be able to enter the unit at the same time, rather than having to remember to go back to the record later to enter the unit. There really is no longer a reason to delay these, especially starting with Using Cognos2 to keep track of patients, instead they become something for which we would need to add tools to CSS to identify them. Please enter them as they show up on Cognos2 Service Starter, or explain why you think it's better not to. Ttenbergen 22:19, 2020 November 25 (CST)

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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.

Entering data for EMIPs

Entering patients in dispo tab fields

• Service/Location field - your Generic HSC_Med, GRA_Med, STB_Med
• Previous Service field - likely emergency medicine, unless some other service accepted them prior to medicine, and was never able to get them out of the ER either, and medicine accepted the patient from them - in order for a pt to be an EMIP they must have been accepted by Medicine for admission otherwise they would just be an Emergency patient
• Accept DtTm field - the time Medicine accepted them, i.e. the time they became an EMIP
• Arrive DtTm field - same as Accept DtTm field
• Previous Location field - use normal instructions

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.

• In Tmp Boarding Loc enter ER with the same Date/Time as Accept DtTm field
• Service tmp entry - Enter the service that accepted the pt, eg. "HSC Internal Med / A Medicine" or "HSC Critical Care / General" with the same Date/Time as Accept DtTm field
• Transfer Ready DtTm / Transfer Ready DtTm tmp entry - only use this if the pt is going home. Otherwise use "not transfer ready".

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)

• if an EMIP patient is transferred to an ICU, that ICU would use e.g. GRA_Med as Previous Location for the new scheme. Before start date of new scheme,Previous Location is site_EMIP
  • For Pre-admit Inpatient Institution = GRA_Med for the new scheme. Before start date of new scheme,Previous Location is site_EMIP
  • For Previous Service = Medicine
• If a pt who starts out on the EMIP track turns into a medicine Boarding Loc patient, collect them as you would any other Boarding Loc patient.

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).

Related articles

Legacy Information

used to be a Service/Location field in the Medicine database until 2020-10 EMIP changes / Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry there used to not be a critical care counterpart, see ECIP for more info since the concept only applied to Med pts and we didn't collect those at CON and OAK, patients in Concordia ER or Oaks ER could not become EMIPs