Guideline for coding organ donation after death: Difference between revisions
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These would be coded with [[Dispo]] as the OR where they are going. They are not dead when they leave, so they are '''not''' "Death - to OR". | These would be coded with [[Dispo]] as the OR where they are going. They are not dead when they leave, so they are '''not''' "Death - to OR". | ||
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* I had one patient where they withdrew care in the unit then went directly to the OR to harvest the organs. What do we do in this case?--[[User:LKolesar|LKolesar]] 08:03, 2019 June 5 (CDT)}} | * I had one patient where they withdrew care in the unit then went directly to the OR to harvest the organs. What do we do in this case?--[[User:LKolesar|LKolesar]] 08:03, 2019 June 5 (CDT)}} | ||
Revision as of 16:53, 2019 June 18
This page explains how we code organ donation after death; it has it's own page because may concepts tie together around this and the information should only live in one place.
Background |
We usually encode death in Dispo; for patients with dx Brain death who are moved to a different location for Organ donor (organ/tissue donation by the donor) this means we lose either the info about their death or their new location. We needed a special case compromise to ensure this is dealt with consistently. |
Transition to new organ donor dispo field use
- We are going to keep the old entries (died - donor and died - not a donor) available, and you don't need to change them for patients you have already entered
- Main office will run a query to change all the old entries to the new version. We need to do this anyway and it is quicker than collectors doing it manually, so don't waste the time to change these to the new format
- For all new patients, please use the new fields (will be rolled later on today. Ttenbergen 09:00, 2019 June 4 (CDT))
Instructions for coding these patients
- Dispo DtTm: sent from ICU to the operating room or to another ICU (consistent with other Operating room visits
- ie not the time of death
Discharge to OR (same or other site)
- Acquired Diagnosis: Brain death
- Dx Date: Date brain death declared
- Dispo: Death - to OR
Discharge to another site ICU for harvesting
Sending site
- Acquired Diagnosis: Brain death
- Dx Date: Date brain death declared
- Dispo: Death - to other ICU
Receiving site
- Acquired Diagnosis: Organ donor (organ/tissue donation by the donor)
- Dx Date: use the Dispo Dt of the receiving site
- Admit Diagnosis: Brain death
- Previous Location: the previous ICU
- Dispo: Hopefully "Death - to OR", or "Death - to morgue" if transplant doesn't work out
Donation after Cardiac Death (DCD)
Donation after cardiac death (DCD) is where a donor who is not brain dead is dependent on life support and the family has decided to withdraw care. When the patient's heart stops beating, the organs are then recovered in the operating room.
These would be coded with Dispo as the OR where they are going. They are not dead when they leave, so they are not "Death - to OR".
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MAID
Medical Assistance in Dying (MAID) is where a person who undergoes MAID has made arrangements in advance for organ harvesting after death.
What are the instructions for this? Would they go through the exercise of declaring such a patient's Brain death or would we capture them as Acquired Diagnosis MAID and Dispo "Death - to OR" or more problematically "Death - to other ICU" ? |
How they are treated in linking
- Populate linking pairs will not be affected since it only looks at PHINs and times
Cross checks that are affected
The following in Correcting suspect links will need to be updated for this:
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How reports are affected
LOS
This should live in LOS when it's all settled since it's not unique to organ donors. leaving it here for now just to keep questions together
- Redefine LOS. From now on, for patients who experience Brain death, LOS will include time from admission to Brain death. Time in ICU spent after Brain death being evaluated/optimized for being an organ donor will not be included in LOS.
- Bed occupancy- But, of course, that time will be included in calculations of bed occupancy.
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other fields that might be affected
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- regular CC (Annual report? If so we should change the name
- Med reports (I can't even find a link for that) reports. For ICU patient, this rule will only affect the SAS linking check program which can be modified so it will not show up as an error.
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Related, but won't be affected:
- Bed occupancy; LOS will not include brain deads, but bed occ. would