GRA ER use as borrow location

There is a strange thing going on at the Grace that leads to situations similar to ECIP.... Made this page to consolidate details here.

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At the Grace, occasionally the ICU borrows beds in the ER. Patients can stay the entire ICU time in the ER, ie if they die or are discharged before ever making it to ICU. These would essentially be ECIPs, which we previously thought didn't exist.

We have an entry for these in Project Borrow arrive.

How are these different from Parked in ER/Direct admit? Where does one end and the other begin?

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Identifying these patients

As per Lisa:

Just to clarify the patient at the Grace was NOT identified through the EPR but was brought to our attention by the manager of the ICU. After the fact I was able to identify this patient through the EPR admit register using the appropriate dates, the ER as a location and filtering for “all “ providers, the patient then showed up on the report under critical care in the ER. We have added this as a regular report we will now run looking for all patients in ER admitted under critical care. This patient was also identified through the medicine admission when the chart and ER notes were reviewed, so this is another way in which we can catch these patients, provided they are transferred to a ward where we collect.

Do we need to change our EPR Report / identification process to make sure we capture these? Just for Grace or for all sites?

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Same situation at STB?

As per Laura:

We had one patient who was accepted to ICU in ER and looks like the pt was cared for by the ICU docs for 6 hours there. The pt did eventually come to the ICU. If you want to identify these patients you should add ER to our boarding list. Otherwise we will put the generic STB board option.

Do we need to add the option to track these for other sites? this is an ER wait/delay case and not to be included in the Project Boarding Loc. The ECIP case is a whole stay in ER but under the Critical Care attending Physician.

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Are these ECIPs then?

As per discussion with Julie, yes they are ECIPs. While they only exist at the Grace we don't need to build a location and collection process for them, since at GRA there is only one ICU collector. If this becomes a thing at other sites as well we might want to reconsider.