Cause
This wasn't a deliberate change. We now pull the start date from first service rather than right from the L_Log table. Once it’s a query like that, the field is not editable directly.
Short-term work-around
For now, you can change the Record field by first opening the record in Patient Viewer.
What do we actually need, here?
Clearly we need a way for collectors to flag a record for Medical Records Requests, the question is how best to accomplish this now that "as before" is not an option. The management of backlog is currently a personal preference. We should have a standard process for this, both to facilitate cross-coverage but also to better be able to use this data to understand workload.
Option 1
Use this as an opportunity to standardize how we manage the Patient List. A different process may no longer require us to change this field around.
I just pulled a list of all record entries for incomplete records, and there are 91 different values in this field.
- a lot of locations use it to track current location of the patient. That is essentially the latest boarding loc, or the dispo, right? If so, I could just display that as part of the list query rather than manually populate it
- at HSC we do some kind of manual MR / MR! / MR* / MR** (12 different values…) annotation – are any of those based on rules that could be data driven instead? And even if not, is this the time to make these uniform? For example, if they are now based on waiting for a hospital dispo, then at least for those where we get that info, we could start entering it and using it for this.
Option 2
Create a different screen that omits Admit DtTm and therefore can have Record field editable. In the end, we mostly need the Dispo DtTm field for this, right?
Discussions
- I don't think we have to see the admit date, dispo date is the most important. A new screen would work, or a new system with checkboxes or something next to names would work as well - although I imagine that is a lot of work behind the scenes for you Tina! Any other ideas?
- I refer to the Admit date all the time as well as the dispo date as it shows patient length of stay (LOS) at a glance, and is very helpful. STB med collectors do not edit the record field from the patient list. Pamela Piche 15:33, 2022 May 9 (CDT)
- We were discussing this at HSC, Pam is right - it is really helpful to look at the admit date as well. Is it possible to make those checkboxes so we can just click off which patients we want on a list for med records? Or is that a bigger IT headache than I realize? Brynn Lezak 07:55, 2022 May 10 (CDT)
- What you are saying is a variation of #Option 1. I would like to do this, but then we would need to standardize how we use this. I am open to working on this. When we discussed this when I dropped by the HSC office the other week it seemed like this would not be a trivial change in process because everyone does what they feel like with the contents of the record field, and we would have to change this to something consistent. Who volunteers to herd the cats? Ttenbergen 11:37, 2022 May 10 (CDT)
- I will Lisa Kaita 14:50, 2022 May 10 (CDT)
- Tina we no longer need the "patient copy" button in patient viewer as we do it all from Cognos now.
- This is likely about the Patient copier button, so if we want to change it we should discuss there. But since we are talking here now I will keep it here for now. The button has no bearing on whether we can edit the list, removing it would not solve this problem. However, does no one use this any more, or just some sites? It's not part of the problem, here, but if really no one uses it any longer I can get rid of it. It seems we were recently discussing that some still enter patients manually under some circumstances. No idea if there would be one to copy in those cases.Ttenbergen 11:34, 2022 May 10 (CDT)
- I think Brynn meant to replace the copier button with a checkbox that would generate the MR list for us if we checked it. We thought it might be a space issue, so that could be replaced Lisa Kaita 14:47, 2022 May 10 (CDT)
- ...However, I wonder does the Notes field need to be visible in the patient list for collectors and whether removal would help?...
- Removing the Notes field wouldn't help solve this, but if it's not needed on this screen we can remove it. Again, use of this field is not really consistent across collectors, so I don't know if any use this in a way where having it in the Patient List is necessary. Open to suggestions. Ttenbergen 11:39, 2022 May 10 (CDT)
- We refer to the notes fields all the time to keep track of profiles where we have counted labs Lisa Kaita 14:47, 2022 May 10 (CDT)
- I refer to the notes field in the patient list as well for quick and helpful info; I made the suggestion for removal as the "lesser of two evils" if the problem was related to a space issue for I prefer the Admit date/time is visible over the Notes field, but really both are useful. Pamela Piche 07:11, 2022 May 11 (CDT)
- In the Patient List I don't use the Notes box often, but if I'm working at home and I know I can finish EMIPs (because the majority of the charting is done in EPR) I'll sort my list by the Notes column to bring my EMIPs to the top. I know not all collectors do it, but when I discharge someone who was an EMIP I'll mark it as an EMIP in the note box for this reason. Now that winter has passed and we shouldn't be getting any more winter storms I may or may not continue in this manner, but that's what I was using it for. Surbanski 10:02, 2022 May 11 (CDT)
Use of the Record Field
HSC
MR when I have ordered the chart
MR1 when I need to order a second list and I haven't finished the first one yet, so I put a number so it doesn't get reordered
MR* when a patient is discharged and I am not ready to order the chart yet
MR** when there is some sort of unresolved issue that I am waiting to deal with (example: can't figure out how to fix an error)
C when complete
And when someone is admitted, I put their current location in the record spot eg. H4, MICU, etc.
- Joyce
- Michelle-I use the record field to give me a quick view on which unit my patients are on, and if they are still under my service. Once they are discharged from hospital, I change them to MR*, then get rid of the asterisk every time I need to make a medical records list. I can only request about ten charts at a time, so every day or two I need to change the MR* to MR in order to create my lists.
- Lisa- MR chart ordered not on shelf yet, MR! chart ordered and on shelf, MR# the date of the current month that I last requested the chart, MR* on list waiting to be requested, MR** usually a lost chart or parts of the chart missing, current location of the patient ie. ward H4, A4 Etc
- Joanna-
GGH
- Sherry: I will use it to track location during the admission to my service (enter their current unit), but once someone leaves my service I change their record to MR even if they stayed within the facility (i.e. transferred to ICU or surgery). I don't go back in to change their record. When I print my MR list I print the pages for the month I'm working on.
SBGH
- Pam-used to track current patient unit location while admitted to service/laptop then record status ie. D/C or C when profile complete. Will enter D/C1, D/C2, etc. to indicate there is a series of profiles for the same patient in reverse chronological order. Will sort patient list by record status to eyeball total number of outstanding discharges or number of patients in ER or on units. Occasionally will enter C*, to indicate there is something needing follow up with specifics in the notes; otherwise the profile is complete.
- Mailah-SB med collectors use the record field to keep track of the pt location/units that we collect under Internal Med service. This also helps to separate discharged profiles requiring completion. I have been using 'board' in the record field for all other units used for off-service/overflow since Covid started or else my record field would be too long and i'd have to be modifying the list as the units changed. The record also contains the DC-C-options. I also use C* if it is incomplete or more chart review required.
- Stephanie
- Val: I put the current location of admitted pt's. ie) ACCU, ICCS, ICMS. W for those transferred to the ward, D/C for those discharged from the facility, MR chart has or needs to be ordered, MR* when a second MR list is ordered and you need to exclude previously ordered but not completed charts, INC if I am waiting for more info/need to follow up on something.
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