JALT Meeting - Rolling Agenda and Minutes 2026
List of items to bring to JALT meeting
Add to this by adding the following to the article where the problem is documented:
{{DiscussTask | JALT
* <question details>}}(this will bring it to Task if not addressed at JALT)
or
{{Discuss | JALT
* <question details>}}(this will not bring it to Task) Toggle columns: Last modified
| wiki page | question | Last modified |
|---|---|---|
| wiki page | question | Last modified |
| Check pre acute consistent | JALT
| 2025-12-17 6:30:28 PM |
| Chronic Health Facility |
| 2026-04-15 10:23:37 PM |
| Chronic Health Facility |
| 2026-04-15 10:23:37 PM |
| Chronic Health Facility | We have discussed lately that we might want to become more nuanced about some chronic care locations (Deer Lodge (DLC) 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.
| 2026-04-15 10:23:37 PM |
| Collection of data on homelessness | JALT
* who should we clarify with, I would think if they have a MB PHIN or are self pay then you would choose MB, if they don't then I would choose Not known Lisa Kaita 21:25, 6 September 2025 (CDT)
| 2026-03-10 1:20:00 AM |
| Data Processor Portal | JALT
| 2026-06-17 10:18:35 PM |
| Discharged to community | JALT
Just a placeholder for now because the idea of how we define dispo to community (or for that matter, re-admit Previous Location) in data came up re. things like Readmission to MedWard and others. We have the obvious "Home" but if someone is discharged to something like Dialysis, would that also count? How do we define? Ideally by a column in s_dispo table such as s_dispo.loc_type, but that one uses "non-patient" which it also uses for Deceased patients (should we just split that out?). There is probably even more to this. Likely Julie has more than one approach in reporting. This came up because we were looking to define this for LAU collection readmission data.
| 2026-01-22 3:40:32 AM |
| 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)
| 2026-06-25 6:41:22 PM |
| John or Jane Doe patient | JALT
| 2026-06-17 2:59:27 AM |
| Minimal Data Set | JALT
| 2026-06-09 10:06:17 PM |
| Patients residing in Manitoba with ambiguous MH Health coverage | JALT
| 2025-08-14 5:06:29 PM |
| PHIN field | JALT Consider this again in the context of mapping our data to DSS. | 2026-06-24 3:49:05 PM |
| Pre acute living situation field | JALT
| 2026-04-26 12:31:03 PM |
| Project NonTradLoc | JALT
| 2026-07-02 5:15:51 PM |
| Project Overstay2 |
| 2025-12-17 5:44:01 PM |
| Query check tmp AHC | JALT
| 2026-01-13 8:58:25 PM |
| Selkirk Mental Health Centre | JALT - Mental Health Facilities in Addition to Selkirk
| 2026-04-14 4:56:36 PM |
| Service tmp post-send consistency checks |
| 2025-11-27 10:44:27 PM |
| Standard data cleaning process |
| 2026-07-10 4:19:38 AM |
| STB Medicine Collection Guide | There was a discussion about the beds that had been "handed to" them... what was the outcome, should it go here?
| 2026-01-06 4:43:51 PM |
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(B)JALT June 29, 2026
- Present: Brooke, Julie, Jen, Allan, Lisa
0. This is Julie Mojica's last meeting, as she is retiring later this week. We appreciate all her great work over the years.
1. Allan reported that, as Tina suggested, he talk to Bojan about the ADT-sourced data from Shared Health that may duplicate what we collect.
- Bojan stated that this "other" data is "not to be trusted"
2. Allan reported that he talked to Bojan about the new-style ICU utilization reporting
- Bojan likes the new schema and feels it adds significantly to the report
- When presented with the problem we'd have in generating these reports soon after the end of a reporting interval, Bojan raised the idea of: (a) changing reporting to only 2 or 3 times/year, and (b) seeking to deliver the report 2 months after the end of the reporting interval.
- Tina and Julie believe that 'b' would solve the problems
- Bojan will discuss this plan with the ICU leadership team
3. New item: After discussion we recognized that the best way to identify patients from ICUs who are transfer-ready to go to IICU (i.e. an IICU consult was performed and the decision was that the patient is appropriate for IICU) is the log book in the IICU
- Lisa will work on developing a mechanism for all the ICU data collectors to obtain this information
4. We went over the list of questions/issues on the Statistician wiki page
5. New item: It appears that the created field of hospital readmissions after discharge from a ward omits those discharged from a Medicine Ward who were readmitted to an ICU.
- Allan will contact Nick to ask him: (a) is anyone using this regularly reported data, (b) what information are they actually seeking, and (c) if 'a' is Yes, then to see if we need to modify the reporting to get them what they want
6. New item: Regarding reporting on decubitus ulcers
- We currently collect substantial details about decubiti, including:
- Separate diagnosis codes for: (i) decubiti in 3 sites, heel, elbow, sacrum/coccyx, and (ii) 6 levels of severity
- Identification of whether they were present on admission or acquired after admission
- A given ulcer that progresses over time will be represented by an additional diagnosis code as it worsens
- However, the quarterly reporting is much simpler, only including the highest severity of any of the decubs
- Apparently, the current reporting is OK with the SICU team (who requested the augmented details be collected), and the OIT group
7. With Julie retiring, and Brooke taking her position, we agreed to call this group (B)JALT, pronounced "jalt" with the B being silent.
JALT June 22, 2026
- Present: Julie, Jen, Allan, Lisa, Tina, Dan
1. Continued discussion regarding: [i] Collection of data on homelessness, [ii] the Collection of locations on the spectrum between home and PCH, and [iii] seeking to deal with the current difference in lists of locations for Pre acute living situation and Dispo -- see JALT minutes from June 10, 2026 for reference
- We showed Dan the long list of specific dispo locations, and the preliminary categorization done by Lisa. Dan & Tina will peruse those lists and get back to us about which categories we should retain
- An issue in regards to this is balancing the extra work for data collectors of using numerous categories vs. the value to the work Dan/Tina are doing in regards to the project to avoid hospital discharge delays
- Tina identified was that it is possible to prioritize dropdown lists so that data collectors are presented first with the most common categories, and the rarely-used categories are at the end of the dropdown list.
2. Final decisions about Sex field:
- As of July 1, 2026 we will implement that change, as per the JALT minutes from June 10, 2026. The new "X" option will include everything except M and F.
- See Guidelines for coding sex and gender for instructions.
3. New item: When there are multiple database records with the same admit date/time, there are sometimes inconsistencies as regards Pre_acute_living_situation field, Province field and Postal Code field
- First, we recognized that there would be benefit to fine-tuning the Pre_acute_living_situation field list, and specifically harmonizing it with the Dispo field list. But before we set about to do that, we will await the work from today's item#1.
- The issue here revolves around which cross-checks to implement, and where in the process to implement them. We'll discuss this more in a subsequent JALT meeting.
4. New item: Regarding postal codes for John or Jane Doe patient.
- After discussion it was agreed that the Wiki documentation for this will only be listed under John or Jane Doe patient, with a link to this in the Wiki page for Postal Code field. Tina will make this change.
5. New item: Regarding appropriate collation of Transfer Delay in situations within Medicine when there are transfers within a single database record between Ward and Hi-Obs AND multiple of these steps have a Transfer Delay
- In the examples below, @, @1, @2, etc represent an indicated transfer delay. And remember that transfer delay only applies to the expectation to be transferred to a LOWER level of care.
- The situation is straightforward when, in the presence of a transfer delay date, the patient goes from a higher to a lower level of care. This is because the transfer delay RESETS once that happens, e.g:
- ex1A) HiObs@ ---> Ward ---> discharge from Medicine: Excess HiObs days are just the #days from the transfer delay until the patient went to the ward.
- ex1B) HiObs@1 ---> Ward@2 ---> discharge from Medicine: Excess HiObs days are just the #days from transfer delay#1 until the patient went to the ward, and the excess ward days are the #days from transfer delay#2 until discharge.
- It becomes unclear when, in the presence of a transfer delay date, the patient goes from a lower to a higher level, e.g:
- ex2A) Ward@ ---> HiObs ---> discharge from Medicine: The problem is that the true excess ward days due to this transfer delay is unknowable, it could reasonably be anywhere between the transfer to HiObs all the way to discharge, or even before than the transfer to HiObs (e.g. if the patient's condition deteriorated soon after the transfer delay notation).
- ex2B) Ward@1 ---> HiObs@2 ---> discharge from Medicine: This example is more complicated than ex2A because Medicine wants to keep track of the excess HiObs days that occur after the onset of transfer delay#2.
- A reasonable, but slightly arbitrary, solution to this problem is that when a patient with a transfer delay date goes to a higher level of care, to assign the excess days as ending on the transfer to that higher level of care AND resetting the transfer delay at that point in time.
- So, for ex2A the excess ward days would go from the ward transfer delay date to the entry into HiObs
- for ex2B the excess ward days would go from transfer delay#1 to the entry into HiObs, and the excess HiObs days would go from the transfer delay#2 until discharge
- ex2C) Ward@1 ---> HiObs --> Ward@2 ---> discharge from Medicine: excess ward days would go from transfer delay#1 to the entry into HiObs, and there will be additional excess ward days from transfer delay#2 until discharge
- ex2D) Ward@1 ---> HiObs@2 --> Ward@3 ---> discharge from Medicine: excess ward days would go from transfer delay#1 to the entry into HiObs, excess HiObs days would go from the transfer delay#2 until transfer back to the ward, and additional excess ward days from transfer delay#3 until discharge
JALT June 10, 2026
- Present: Julie, Jen, Allan, Lisa, Tina
1. Continued discussion about collecting the Sex field. After assessing what is done in BC and by CIHI, and further discussion, we agreed to a simpler solution, as follows:
- We will seek to collect "Sex Assigned at Birth"
- Instructions for data collectors:
- Initially take what is provided by Cognos (which currently is one of Male, Female, Undifferentiated or Unknown, but at some point in the future these may change) --> if while reading the chart the collector discovers that what is listed by Cognos for the current record is different from the Sex Assigned at Birth, then change the current Sex listing to whatever it was at birth.
- Example: Cognos lists Male, but chart reading demonstrates that this individual had sex reassignment surgery with the Sex Assigned at Birth being Female, then change the sex listing for this record to Female.
- Initially take what is provided by Cognos (which currently is one of Male, Female, Undifferentiated or Unknown, but at some point in the future these may change) --> if while reading the chart the collector discovers that what is listed by Cognos for the current record is different from the Sex Assigned at Birth, then change the current Sex listing to whatever it was at birth.
- Instructions for Pagasa:
- If the Sex field for a new record differs from that of an earlier record, change the new record Sex field to be consistent with the earlier record
- Julie will begin reporting sex in both ICU and Medicine data reports as M, F and X
2. Continued discussion regarding: [i] Collection of data on homelessness, [ii] the Collection of locations on the spectrum between home and PCH, and [iii] seeking to deal with the current difference in lists of locations for Pre acute living situation and Dispo
- Julie's collation of temp data collection:
- There are approximately 300 separate locations --> Lisa did some work categorizing them, which showed:
- 71 locations are not yet categorized --> Lisa will continue to work on these, in particular identifying those for which we already have a category
- The remaining locations were split into about 25 categories
- some are frequent but over half of these categories have 1-4 individuals
- about 10 of these categories are already closely related to existing discharge location categories
- There are approximately 300 separate locations --> Lisa did some work categorizing them, which showed:
- Since a major purpose of this effort has to do with the work being done by Dan & Tina regarding timely hospital discharge, we will continue discussing this topic at the next JALT meeting on June 24, and try to make sure Dan can be present so final decisions can be made about which categories are needed/not needed.
JALT May 6, 2026
- Present: Julie, Jen, Allan, List, Tina, Pagasa
1. This entire meeting was taken up in discussion about modification of the Sex field
- Currently we code it in a binary fashion, just M or F with reference to biological sex at birth. However, even this is not always that easy, due to: the existence of sex reassignment surgery, trans-sexualism, intersex status, the fact that since 2022 Manitobans have been allowed to change the sex on their birth certificates, and the even more complex issues of gender identity.
- We get sex information from Cognos, which currently allows entries of: "M", "F", "undifferentiated" and "unknown", so in general the data collectors don't manually input that information.
- From information Tina gleaned from the ADT data, it appears that these sorts of issues arise in approximately 1/1000 persons. This is consistent with Pagasa's sense that she finds inconsistencies in the Sex field (i.e. current record vs. prior records) no more than a few times yearly.
- THUS, after discussion we agreed that as of June 1, 2026, we will make the following changes:
- The Sex field will allowed to have entries of "M", "F" or "X", where X represents any/all uncertainties about biologic sex, i.e. to the extent possible we are NOT trying to discern gender identity
- After confirmation in the EPR, X will be coded if Cognos identifies sex as undifferentiated
- After confirmation in the EPR, if the current Cognos record lists sex as unknown, and there are prior database records where it WAS known, then Pagasa will change sex in the current record to be consistent with past records (either M, F or X)
- After confirmation in EPR, if there is inconsistency between sex in the current record and sex in past records, Pagasa will change sex in ALL of them to X
- Data collectors may come across information in the chart indicating uncertainty about biologic sex as listed in Cognos -- such information can include evidence of sex reassignment medications and/or surgery, or procedures inconsistent with the sex field in Cognos (e.g. hysterectomy done in a patient whose Cognos sex field is M)
- When such things occur, collectors should list the Sex field as X
- Given the very very complex landscape of self-identified gender, and the large number of young adults who prefer they/them pronouns, it is important to recognize that (to the extent possible) we are still trying to identify sex, not gender.
- Thus, do not list the Sex field as X only on the basis of preferred pronouns or gender identity -- i.e. we are trying to discern biologic sex, to the extent that that is a well-defined concept.
- Lisa & Tina will edit the relevant Wiki pages
2. We did not get to any of these things to be discussed:
- Service/Location field
- Awaiting/delayed transfer to long-term care/PCH inside or outside of Winnipeg and how this may be related to Transfer for bed management
- check pre acute consistent
- Project NonTradLoc data review per Tina
- Patients residing in Manitoba with ambiguous MH Health coverage
- Collection of data on homelessness data review and how this relates to Postal Code field
- Chronic Health Facility need to finally clean up these long protracted conversations
JALT 2026-3-4
- Present: Tina, Julie, Jen, Lisa, Allan, Dan
- Minutes by: Allan
1. Lisa reported that the collectors have begun using the Transfer for bed management and Intended1stSrvc, without major problems.
2. Allan reported that after previously contacting Dr. Hajadiocos in regards to ward patients on non-GIM services, and being told that Dr. H will arrange a virtual meeting with those groups, he has not heard back again.
3. New item -- adding new "admit from/transfer to" sites, e.g. Eden Mental Health Centre
- Lisa already can make such additions to the S table
- It currently appears that mental health facilities (e.g. Selkirk Mental Health Centre) are being classified under PCH, which is incorrect. We agreed that we will add "Mental Health Centre" as a new category of healthcare site
4. New item -- Dan/Tina explained that for their bed movement efficiency work, they are replacing LOS with a different parameter,
- This new parameter is defined over any given time interval as: Total # of bed-days/#Discharges
- it is a superior measure of discharge efficiency that smooths out short-term fluctuations and LOS outliers, and in asymptotically equals average LOS
- They are already using this index for ward patients
- After discussion, we agreed that while this index might be useful for ICUs also, we will delay reporting it until we finalize the new-style ICU service and ICU bed reporting
5. Next JALT meeting will be April 16, 2026
JALT 2026-1-22
- Present: Tina, Julie, Jen, Lisa, Allan, Dan
- Minutes by: Allan
1. A lot MORE discussion about Transfer for bed management
- With Dan's help we DEFINED this concept: A transfer for bed management is a transfer (remembering that it only applies to transfers at the same level [ICU-to-ICU or ward-to-ward] with the single exception of going from ward to LAU) that is NOT to benefit the patient, but rather to benefit the bed system. The alternative is a transfer that is to benefit the care of the patient, e.g. transfer from Grace ICU to MICU for dialysis.
- We also agreed to define hospital repatriation as transfer back to a hospital outside of the WRHA. Tina made this change on the Transfer for bed management page.
- Tina indicated that there are other groups working on bed capacity issues, and suggests we interface with them. Tina will send contact info and Allan will make contact.
- Dan clarified that as those other groups do NOT (currently) possess any clinical details about patients, that their efforts regarding capacity and bed needs must be incomplete. As WE have the clinical detail (and chart review by experienced nurse data collectors) for medicine wards and ICUs, there is potential there for collaboration.
- Allan has modified the Transfer for bed management wiki page to provide some general guidance for using this code for ICU-to-ICU transfers.
2. Followup regarding ward patients on non-GIM services, particularly Nephro, Neuro, Resp
- This is very confusing for many reasons, including:
- Some of these patients are physically on Medicine wards, but others are not
- Nephro, Neuro and Resp have their own wards, in some hospitals
- Some of these patients might be on a GIM ward and cared for by GIM housestaff but the official attending is not GIM (e.g. Nephro)
- Other of these patients might be on a GIM ward cared for as non-teaching by a subspecialty attending (e.g. Nephro) -- but as we don't know about this, they are included in GIM ward reporting by Julie
- The mixture of all these alternatives change over time
- The Medicine Database is not informed and therefore not kept up to date on all of this confusion
- Indeed, to accurately track all of this requires that we get real-time bed assignment information (IF it exists)
- The Service tmp entry from ADT via Cognos provides some clarity on the actual service caring for each patient, though Julie has found that for ward patients this is incorrect in a minority of cases (probably correct in >90%)
- Allan reported that he contacted personnel from Department, GIM, Neuro, Nephro,and Resp -- and only heard back from Renal Transplant and Resp.
- Given that, Allan has emailed Nick to ask him if/how he wants to proceed on this.
JALT 2025-12-18 (Copied for continuity, delete once the first new minutes for the year are in here)
- Present: Tina, Julie, Jen, Lisa, Allan
- Minutes by: Allan
1. 2025-05 Revision of concept around ICUotherService / Intended1stSrvc]] - We finalized decisions relating to concepts around service, location and ICU reporting.
- We agreed that the options for the dropdown listings should all be the same for Boarding Loc, Service/Location, and the new field Intended1stSrvc, and that these will be the same as those currently used for Boarding Loc, i.e: HSC-MICU, HSC-SICU, HSC-IICU, STB-MICU, STB-CICU, STB-ACCU and GH-CC
- We recognize that these will then be different from the "official" ADT services listings provided to us in Cognos2
2. Definition of a Medicine Program Admission - There was extensive discussion about ward patients on non-GIM services, particularly Nephro, Neuro, Resp
- This is very confusing for many reasons, including:
- Some of these patients are physically on Medicine wards, but others are not
- Nephro, Neuro and Resp have their own wards, in some hospitals
- Some of these patients might be on a GIM ward and cared for by GIM housestaff but the official attending is not GIM (e.g. Nephro)
- Other of these patients might be on a GIM ward cared for as non-teaching by a subspecialty attending (e.g. Nephro) -- but as we don't know about this, they are included in GIM ward reporting by Julie
- The mixture of all these alternatives change over time
- The Medicine Database is not informed and therefore not kept up to date on all of this confusion
- The Service tmp entry from ADT via Cognos provides some clarity on the actual service caring for each patient, though Julie has found that for ward patients this is incorrect in a minority of cases (probably correct in >90%)
- Some of these issues relate to data that might be useful for the work being done by Dan & Tina on moving patients through the system
- We are unsure how much of such detailed, cumulative data, about all this is desired by the administrative heads of the Department of Medicine and some of the Sections
- although per Julie and Lisa, Nick H. did request that we collect on the new Nephrology Transplant patients on B2 at HSC
- ACCORDINGLY -- given all this confusion, Allan has sent an email to the leadership of: Department, GIM, Neuro, Nephro, Resp, along with Dan --- proposing that a meeting get set up to:
- First -- understand the wishes of those stakeholders for cumulative data on their various ward patients
- Second -- Figure out how we could provide such reporting
- Third -- come back to the stakeholders to explain what ongoing information would be needed for us to provide that reporting (e.g. being kept appraised of the agreements between GIM and the subspecialties about use of GIM ward beds).
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Ttenbergen 22:17, 18 December 2025 (CST) |
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For earlier minutes see JALT Meeting - Rolling Agenda and Minutes 2025