JALT Meeting - Rolling Agenda and Minutes 2025

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List of items to bring to JALT meeting

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Chronic Health Facility 2025-06-25 8:18:02 PM
Chronic Health Facility
  • This issue raised a problem with medicine data recently, and we will review again if this needs to be coded more granular after all,
  • dicussed at JALT June 25, 2025 while Bojan would like this it is not possible to keep track of unit changes and not always easy to tell which unit they arrive from so leave a Riverview and Deer Lodge, with the exception of the PCH units in each facility.Lisa Kaita 14:52, 25 June 2025 (CDT)
    		•  2025-06-25 8:18:02 PM
    Chronic Health Facility We have discussed lately that we might want to become more nuanced about some chronic care locations (Deer Lodge and Riverview). I have removed the details from the above linked fields and consolidated here. Once this page is cleaned up this discussion entry can be removed.
  • Discussed at
    		• 2025-06-25 8:18:02 PM
    Dispo field JALT

    I thought we had decided at JALT to collect this as presented by EPR... do I remember this wrong? I had already added it in CCMDB.accdb Change Log 2025#2025-03-11-1. Ttenbergen 22:52, 11 March 2025 (CDT)

    • Yes, I saw that, come to think of it I don't think we decided, not in my notes, but we can use it and I will change the wiki instructions Lisa Kaita 11:25, 13 March 2025 (CDT)
    • If we are going to collect this detail for dispo, should we consider whether or not to also look at SH in preadmit living situation?, currently lumped with community facility with support. Lisa Kaita 14:45, 16 April 2025 (CDT)
    • The entry name includes "TRSF" - is the entry for the previous location equivalent in EPR? Ttenbergen 23:30, 16 April 2025 (CDT)
    • no because the previous location would usually be <site>_ER Lisa Kaita 09:53, 28 May 2025 (CDT)
      • Sorry, I should have asked about "pre-hospital location in ADT". Ttenbergen 16:21, 28 May 2025 (CDT)
    		 2025-07-08 1:24:19 PM
    Patients residing in Manitoba with ambiguous MH Health coverage JALT
  • The page name isn't quite right, this concept is still evolving in documentation.
  • Some of these may be better off broken out as their own pages or templates and only indexed from here.
    		•  2025-06-25 7:09:17 PM
    Postal Code Master table JALT
  • Management of this table has always been driven only by resolving inconsistencies query NDC_Bad_Postal_Code, and there have not been cross checks for this table itself. We found 2025-06 that there were inconsistencies between postal codes and province entries in this table, and Pagasa found duplicate postal codes. Also, we do not have a central process to update postal codes as new ones are added to the system. Do we need a formal process? Is the current ad-hoc process enough. Or do we need a decision on allowing these inconsistencies and just documenting them? Ttenbergen 15:55, 24 June 2025 (CDT)
    		•  2025-06-24 8:55:48 PM
    Pre acute living situation field JALT should we be including Misericordia TCU here? Lisa Kaita 11:57, 5 June 2025 (CDT) 2025-06-05 4:57:52 PM
    Service/Location field
  • is this section still current? Ttenbergen 11:13, 6 March 2025 (CST)
  • It up for discussion tomorrow at JALT Meeting - Rolling Agenda and Minutes 2025 Lisa Kaita 21:04, 10 March 2025 (CDT)
  • Allan spoke with Bojan, to be discussed at next JALT Lisa Kaita 14:48, 16 April 2025 (CDT)
    		•  2025-04-16 7:48:25 PM
    Standard data cleaning process
  • While discussing Visit Admit DtTm differences within same admission at JALT Meeting - Rolling Agenda and Minutes 2025#JALT 2025-03-11 I realized we don't have any part of your "cleaning" process documented. We should, even if it is a rudimentary notice of the SAS files you use and what you check for. Ttenbergen 21:51, 11 March 2025 (CDT)
  • If there is linking beyond Populate linking pairs, or if you use a different linkage, we need to document that as well; do you? Ttenbergen 21:51, 11 March 2025 (CDT)
    		•  2025-03-12 2:51:43 AM

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    • New Item Collector Coding- Patient and laptop profiles- ADL and Charlson discrepancy, See Tina's email forwarded to JALT members May 29, 2025
    • ICD10 categories, see Tina's email Nov 6, 2024, forwarded to JALT members

    JALT 2025-06-25

    • Present: Tina, Julie, Jen, Lisa, Allan
    • Minutes by: Allan

    1. We spent most of this meeting continuing discussion about tracking services and locations.

    • BACKGROUND:
      • There are 3 basic variables to track: Service the patient should be on; Service the patient is on; Actual physical location of the patient. From the POV of any given ICU (e.g. MICU) there are then 5 relevant patient categories:
    Group Service should be on Actual service Actual location Meaning
    A mine mine my ICU my natural patients
    B mine mine different ICU my boarders elsewhere
    C different different my ICU somebody else's boarders in my ICU
    D mine different different my "double boarders" elsewhere
    E different different my ICU somebody else's "double boarders" in my ICU
    • B+D means insufficient beds in my ICU; C+E means insufficient beds in other unit(s)
      • The current quarterly reporting "by unit" is currently (per Julie) actually by service (i.e. A+B+E), but in discussion with Bojan, he told Allan that he has always wanted and assumed he was getting by physical unit (i.e. A+C+E).
      • We currently have 4 variables that have been, or are, used to identify services and locations:
        • Boarding Loc -- tracks the patient's actual physical location; can change
        • Service tmp entry -- tracks the service taking care of the patient; can change
        • Service Location -- is the INITIAL service that cared for the patient at hospital admission; does not change. Of note, this field is used to create the unique record identifier and for other purposes unrelated to the service caring for the patient. Thus, not only would it be problematic to delete it, but even renaming it would cause problems.
        • ICUotherService -- this is a temp entry that can change over time, and is currently only used at St. B. It contains 2 bits of information, e.g. "ACCU under MICU" means that the patient should be in ACCU on ACCU service but is in MICU on MICU service.
      • We recognize that this data infrastructure is confusing and contains some duplication. Here is a suggestion of being able to accurately track all of A, B, C, D and E in the simplest way and with the smallest amount of modifications to existing data infrastructure:
        • Keep the current meaning of Service/Location but make very clear in the Wiki that it is a legacy-type field we still use but not to consider it part of the clarification of actual service or location
        • Keep Boarding Loc and Service tmp entry with their current meanings
      • Alter the meaning of ICUotherService to be the service the patient SHOULD be on. With this simplifying change to the coding of this field, we can unambiguously use these 3 variables to partition care into A, B, C, D and E. We then must re-decide on the criterion that leads us to create a new ICU record. Currently it is when the actual service changes.
    just came across Proposed future changes to Location and Transfer Ready and related fields about a previous consideration to changing related fields. Ttenbergen 13:28, 27 June 2025 (CDT)
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    JALT 2025-05-29

    • ICUotherService/Service Location/Boarding Loc/Service tmp entry - This entire 2.5 hour meeting was about the very complicated issues that relate to patient's: physical location (Boarding Loc), actual care service (Service tmp entry), and where the patient "should be" (which is currently coded in "Other ICU", and Service Location).
      • This is made even more complicated in that Service Location also serves functions related to "grouping" for reporting.
      • Other issues that relate include: what alterations in locations and/or service should result in starting a new record; how to code Dispo field and Previous Location in the case of ICU-to-ICU transfers with creation of a new record.
    • After discussion we agreed that the next step will be to clarify precisely what kinds of reports are desired by our users. In this regard, Allan has worked out a schema for classifying patients based on 3 binary characteristics, and will discuss it with Bojan
      • Physical location of patient
      • Current care service of patient
      • Which service the patient "should be on"

    JALT 2025-03-11

    1. Visit Admit dttm discrepancies, see Visit_Admit_DtTm_differences_within_same_admission
    2. New disposition options- barriers to discharge and how best to capture this, Dispo_field
    3. Chronic_Health_Facility⚓
    4. Alternative_Integrated_Accommodation_(AIA)
    5. Service/Location field Revisit MICU overflow in SICU
      • in context also of ICUotherService, Service tmp entry and Boarding Loc and STB CC
      • Allan spoke on March 14 with Bojan about the wishes/needs of Critical Care regarding this:
        • The "basic" information provided by Boarding Loc and Service tmp entry enable tracking patient-days boarding (defined as a patient cared for by Service A but in location B) -- but they do NOT need to know which location B (e.g. an MICU patient boarding in SICU vs. JK)
        • They do want to be able to track the number of patient-days in which a patient who would normally go to ICU A, instead is in ICU B where they are cared for by Service B. This is something that is now tracked by the complicated Service Location field. A simpler alternative to track this could be to have for each ICU record an optional field that identifies it (perhaps called "ICU other service") which has options such as "ICU other service-MICU", "ICU other service-SICU", etc, indicating the ICU service the patient "should have been on"
          • Example: A patient that would normally be cared for in ICCS, but ICCS is full. So the patient goes to ICMS on the ICMS service. Here loc=ICMS, Service=ICMS and this database record has a flag for "ICU other service-ICCS".
    • Could you summarize what we would need to change from ICUotherService to get to this? It sounds similar. Ttenbergen 13:25, 17 March 2025 (CDT)
      • in the example mentioned, the service is STB ICMS and flag in the tmp ICUotherService with item entry CICU under MICU service which is ICCS under ICMS service. the current list we have is clearer and less confusing than ICU other service- MICU. And when this patient is accepted to the STB ICMS as an ICMS patient, we continue the profile and the tmp ICUotherService will have a new line with entry MICU under MICU service. Such profile then will have part of ICMS service as an ICCS patient and as an ICMS patient. In the qtr report, this profile is included in the ICMS unit. However, a separate report if requested can be done if wanted to know the LOS of overflowed patients on borrowed service. --JMojica 17:30, 7 April 2025 (CDT)
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    For earlier minutes see JALT Meeting - Rolling Agenda and Minutes 2024

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