Parked in ER tmp entry

A patient is considered parked in ER if they are a direct admit who gets stuck in the ER.

general instructions from Direct admit

For patients who get parked in the ER during a inter-facility transfer, enter the previous ward in Pre-admit Inpatient Institution field and enter your ER in Previous Location field. (In the past you would have entered the hospital and ward as the "admit from".)

Collection instructions

Into Pre-admit Inpatient Institution field, enter Template:Discussion

Into Previous Location field, enter Template:Discussion

Into Previous Service field, enter Template:Discussion

Possible Entries

• HSC - ER (direct)
• GRA - ER (direct)
• CON - ER (direct)
• OAK - ER (direct)
• VIC - UC (direct)
• STB - ER (direct)

from VIC ICU Collection Guide

See also Dispo_field#Discharge_to_ER

• On rare occasions, a patient who has become unstable/codes on the ward will be transferred to the ER if a bed is not yet available in the ICU. If these patients have been accepted by MICU attending, then these patients should be entered into the ICU computer, with an admit location from the ward that they came from, and an admit time of when they arrived in the ER from the ward. These patients are transferred to the ICU once a bed is available. If patient dies prior to arriving in the ICU, they should still be entered into the database. Document in the notes field time of transfer from the ER to the ICU.

Template:Discussion At the Concordia the patients will occasionally go from a ward to emergency because they are unstable and then are admitted to ICU. There often is no real documentation the the ICU doctor accepted the patient prior to the physical arrival in ER or ICU. Times of arrival to ER from the ward are in EPR but may not be accurate. Other recorded times may not be available. What do you want collectors do do? Are we supposed to guess, or just use what is in the EPR as an arrival time to emerg as our admit time to ICU? GHall 07:48, 2016 November 10 (CST)

from Pre-admit Inpatient Institution field about OAK_MICU

• Patients that are admitted to a ward at SOGH and become unstable may be transferred to the SOGH ER for determination of problem and disposition. If they are deemed critically ill and are an ICU candidate, they are then admitted from the ER to SOGH ICU. This is not a consistent practice but does occur on a regular basis. Main office notes that my pre-admit inpatient field is Oak-Ward but my previous location is Oak-ER and is an outlier compared to everyone else.

The question to other data collectors is: is this only a SOGH phenomenom? If it is occurring at your facility, does it occur only rarely which is why the data has not shown this elsewhere? Or is your coding different in these cases? --Lpruden2 14:37, 2016 October 13 (CDT)

• At the VIC, the only reason that I have seen patients making a stop in the ER is when they have been accepted to the ICU, but the bed is not yet available. They sometimes will be cared for in the ER until the ICU bed is ready. This is a rare occurrence-I would estimate that it only happens once or twice a year. Mlagadi 10:05, 2016 October 17 (CDT)
  • It looks like what Lorri describes only happens at the Oaks, then. How should we code it there? I have added a link from Oaks_ICU_Collection_Guide#Data_Collection to this article to make sure a visiting collector can find this. Ttenbergen 10:40, 2016 October 20 (CDT)
  • The same thing happens at Concordia that Lori described for SOGH. Patients go to the ER from the ward for treatment and assessment then to ICU.GHall 17:19, 2016 October 20 (CDT)

CON

CON_ICU_Collection_Guide#Transfers_to_and_from_the_Conc_wards

from Dispo

If a patient is discharged to another ER, put discharge to home. Then email Pagasa to tell her which ER the pt was discharged to. We don't want ER to be available in the dropdown because it had been mistakenly entered a number of times. If it turns out there are a lot of legitimate discharges to ER we will make the option available. (discussed with Julie and Trish)

from Previous Location field

Pt was examined & treated in the Selkirk ER (but not admitted as an in pt.) & then sent as a direct admit to HSC but stopped in HSC ER & was treated there till a ward bed was ready. Code as

• Previous Location field: HSC ER
• Previous Service field: Emergency Medicine
• Pre-admit Inpatient Institution field: NA / not applicable
• yes, the Selkirk ER would not be reflected in collection

related concepts

• Off ward field
• Category:Overflow
• EMIP
• ECIP