| | Who | DiscussQuestion | ModDtTm"Modification date" is a predefined property that corresponds to the date of the last modification of a subject and is provided by Semantic MediaWiki. |
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| Charlson Comorbidity Index | Julie |
- Do we ever include the age in the Charlson score? Should we? If not, we need to clearly document that, since others looking at this score would expect us to use the original definition. Ttenbergen 11:03, 28 January 2025 (CST)
- No, the one I had provided with label =Charlson Score has no Age , just sum of all categories. The APACHE SCORE for sure has the AGE score and not Charlson Score. --JMojica 11:26, 28 January 2025 (CST)
- Did we include age as part of the data used to generate the Overstay model? We need to use whatever we used for that in our score and generator.
- The problem is I did not see the final overstay model and I'm only relying on what was on the WIKI Overstay Predictor Project Algorithm showing the AGE and AgexADLmean. In Rodrigo's model, Age is included. I would presume Leigh Anne also included it.--JMojica 11:26, 28 January 2025 (CST)
- I just re-read your original answer, and it actually addressed my question: any Charlson Score you gave them did not include that age factor. I am pretty sure the official Charlson score does include an age factor, I implemented it in CCMDB (not CFE for some reason) "L_ICD10_Charlson_Agepts" query. We had this conversation before, but then I didn't document what was the reason to omit the age from the score. It makes a significant difference to the score, so whoever uses our data (eg is it included in our dump to MCHP) would expect it to include the age portion. Ttenbergen 18:08, 29 January 2025 (CST)
| 18 March 2025 22:18:15 |
| Chronic Health Facility | all
Lisa
Tina | 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.
- review, that might need to be consolidated with this page as well.
- These should be made consistent with Template:PCH Riverview Deer Lodge and should probably use that template to enforce consistent use. Ttenbergen 14:23, 2024 October 16 (CDT)
- and I have lost track of the details Ttenbergen 10:45, 2024 November 1 (CDT)
- There might be an easy way out of this question. We now only have one awaiting code; if waiting for any of them qualifies for this code then we may not need to know about the level of care. But then again, some of those sites also have acute/LAU type settings so we may need to figure this out after all...Ttenbergen 20:27, 2024 December 11 (CST)
Here is the breakdown
- Riverview-
- PCH- C and D wings floors 1-4 42 beds
- PCH- Aand B wings -locked unit for alzheimer/dementia 30 beds
- 2E is LTV 30 beds
- 3E is palliative care 30 beds
- 4E is stroke rehab 30 beds
- 4W is Acute brain injury- 10 beds
- 3W is PCH- 29 beds
- 2W respiratory ward (no vents)- 30 beds
- Deer Lodge
- Rehab wards are Lodge 2W, 4E and 4W
- TCU is Lodge 2E
- chronic care is Lodge 5E, 5W, 6E, 6W, 7E and 7W (clients with comples medical issues who can't be cared for in PCH ie. tracheostomy, ostomy, enteral and parenteral nutrition, complex wound care, blood transfusions and PIV and Central lines.
- PCH is Tower 3N, 3S, and 4,5,6,7 and also Lodge 3W, 3E
Lisa Kaita 13:03, 10 March 2025 (CDT)
- Do we need to consider 1010 Sinclair separately as well?
- Any others we might need to consider separately?
in s_dispo, Riverview has inpatient checked, Deer lodge does not. When all this is settled they should probably become consistent... but not sure which so not now. | 20 March 2025 02:47:21 |
| ClientGUID field | all |
- Lisa, any idea why this might be happening from a collection perspective? Is the problem in what we receive the right info from Cognos, or is there an issue in the collection process that makes this happen? Ttenbergen 09:52, 2024 December 5 (CST)
- Julie, do we need to flag anywhere further that this data is suspect? Ttenbergen 09:52, 2024 December 5 (CST)
| 5 December 2024 15:52:23 |
| Dispo field | Lisa
all | That more detailed info included things like HSC Lennox Bell; we discussed whether or not we need to document the details of this. If so, the following is likely a starting point:
- Home
- Home with support
- Institution NOS
- TRSF Group/Supportive housing
- TRSF to Correctional Facility
- any Hospices
- GH-Transitional care
- HSC - Transitional care
- Misericordia - Transitional care
- STB - Transitional care
- VIC - Transitional care
- HSC Lennox Bell
- Manitoba Adolescent Treatment Center - unknown/other
If this is actually done then why don't we just make the nursing stations available? We already have s_dispo table entries for them. 35 entries since 2016, 6 in the last 12 months. Are there other things for which this entry is used? Checked for reasons for this decision but they don't appear documented Ttenbergen 19:42, 13 March 2025 (CDT)
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)
| 17 April 2025 04:30:33 |
| ER Delay | all
Julie |
I have re-updated Created_Variables_Common_maker_2021 query, for some reason the change I had made was not reflected in the master version. Ready to test. Ttenbergen 13:25, 2022 June 28 (CDT)
- emailed Tina some inconsistencies found in ER Delays Aug 15,2022. --JMojica 13:21, 2022 August 29 (CDT)
- are these still an issue? Ttenbergen 11:15, 2024 May 1 (CDT)
- I will re-check again. Can't remember if have been resolved. --JMojica 14:40, 2024 October 2 (CDT)
- I just had a look at that sas file (they open as text files) to see how you define transfer delay. If that file is still being used we may have a problem, it still defines tdelay different if a pt goes to a higher level of care, goes AMA or dies, and we changed that some time ago. So is this still the reference of how you calculate this? Ttenbergen 22:50, 2024 November 16 (CST)
- This data is problematic before 2011-Q2,the only reason there are any is because it derives them for EMIPs. Some data may be available in Moves for Medicine, but that would still leave a gap. Ttenbergen 23:09, 2024 November 16 (CST)
- OK, will be working on this getting data from Moves for Medicine from period Sept 2007 to June 3, 2011. will give to Pagasa for upload to Arrive DtTm field. I will update the WIKI as soon as done. Conclusion: for Medicine, prior Sept 2007, no ER delay while for Critical Care, no ER Delay prior July 1, 2016 -- these are treated as missing. --JMojica 16:35, 2024 December 11 (CST)
| 18 March 2025 22:18:16 |
| L TmpV2 multi-entry clean-up | Julie | Did we ever resolve this? What was the outcome? If we didn't resolve it, do we still need to? If not, can we delete this page? | 15 March 2025 03:15:57 |
| LAU LTC consult | Tina | for this field the default entry for yes is the LTC Medical application, however I later realized that this is not a consult per se, as some have this completed without an actual consult to LTC (the learning process for this project was confusing, I should have spoken to someone from LTC before starting this) I continued to enter it this way, but also answered "yes" for those that had an actual LTC consult where the dttm were either earlier than the medical application or they did not have a medical application but had a LTC consult, I noted details in the Q column and the notes. I know this is an analysis nightmare but I think I can clean this up if before Julie does her analysis I go through these records Lisa Kaita 07:44, 11 April 2025 (CDT) | 11 April 2025 12:44:51 |
| LAU OT/PT consults | Lisa |
- Do we want an instruction if sign-off isn't found?
- Can I use the no consult entry?
- there is only one of those, so if more than one thing is missing we might not catch it. Aside from that, this would work. So, might be good enough.
- So I interpreted this differently, not sure why or how but what I collected was the first date and time seen by OT/PT (not the consult dttm) and then the last time seen or sign off by OT/PT, For Geri rehab and pretty much all LAU patients the consults are done as part of the admission process. The exception is some of the patients will not be seen by one or the other or both if they are "too good" Lisa Kaita 07:06, 11 April 2025 (CDT)
- Do we want that cross-check entry? Do we need one for each or is a simple "no consult" if there is neither consult sufficient?
- If the entry is missing then they were not seen, I don't think a cross check was set up for this, because it did not trigger any errors Lisa Kaita 07:06, 11 April 2025 (CDT)
| 11 April 2025 12:06:55 |
| LAU Public Trustee | Tina | I also used this field for FORM 21 but documented it in the Q column, should we take this out? I think there were a handful of these Lisa Kaita 07:27, 11 April 2025 (CDT) | 11 April 2025 12:33:49 |
| LAU collection readmission data | Lisa |
- what if they spend time in an ED in between as part of re-admission, possibly pushing past the 7 day range? Due to the very long ER delays for LAU I think we would want to include those. Ttenbergen 00:06, 12 March 2025 (CDT
- These would be included because I am using the ADT/EPR readmits and the admit time reflects first time of presentation and an ensuing admission Lisa Kaita 12:13, 10 April 2025 (CDT))
- to be perfectly clear: if someone is discharged from LAU on Jan 1, and then presents to an ED at GRA, where they decide the person should go to LAU, but the patient is not transferred and made an inpatient again at an LAU for another 3 days (pushing their new admission past the 10 day window), would you tag them as a re-admission? Ttenbergen 12:42, 10 April 2025 (CDT)
- Yes, I believe it would because in EPR for patient visits, the patient you describe would show them as an inpatient, beginning Jan 7, even though by our definition they are not an inpt til the LAU folks accept them. I would not be able to decipher the actual first service time without having the chart or running an EPR report. Lisa Kaita 12:49, 10 April 2025 (CDT)
| 12 April 2025 02:44:57 |
| Overstay2 data processing and reporting in CFE | all
Tina |
- Nothing yet, fill in as it becomes available.
- add functions/subs when I finalize this
| 23 February 2025 22:13:18 |
| Overstay2 processes on the units to reduce overstay | all |
- We'll need to fill these in as they become available; that may well be as links to other documents, since the unit documentation would not be on this wiki. If files are generated we should link to them at their home location, but also maintain files on this wiki, since link rot is inevitable for this sort of thing. Ttenbergen 15:45, 23 February 2025 (CST)
| 23 February 2025 22:22:38 |
| Overstay2 scoring model | all |
- add the content for the chosen model 8 here, with links
| 28 February 2025 21:00:24 |
| Project Consults data | Tina | this is more of an observation than anything, I found that often HC is consulted very early, but they don't actually document in the chart until very close to discharge, I assume they are following these patients, likely during rounds, and waiting until they are medically stable. the item PCH panel, is interesting because the team often knows they need LTC but cannot proceed to panel without the approval of LTC, and getting the approval of LTC can be a lengthy process Lisa Kaita 07:53, 11 April 2025 (CDT) | 11 April 2025 12:53:28 |
| Project MR | all |
- Do we want that to be the first time during a medicine program admission, or only the first time during a hospitalization? Ttenbergen 08:45, 26 February 2025 (CST)
- Also, we define Transfer Ready DtTm tmp entry to be able to do this per level of care to enable reporting separately for HOBS. I think there are problems with that concept since I doubt users of the data keep the detailed definition in mind, but we still need to decide if we want to be able to report this the same way. If so, we need the the same connector integer in the instructions. Ttenbergen 08:51, 26 February 2025 (CST)
- emailed DR about this Ttenbergen 11:36, 28 February 2025 (CST)
- How do we want to define where to get this? Unless we get physicians to put this information into a specific spot we are right back to all the definition difficulties in Transfer Ready DtTm tmp entry, only it will be worse because collectors will need to keep conflicting but similar instructions in mind. Ttenbergen 08:49, 26 February 2025 (CST)
- emailed DR about this Ttenbergen 11:36, 28 February 2025 (CST)
| 28 February 2025 17:36:05 |
| Project Overstay2 | Julie
Tina
all |
- OutsideWPG - I have used Previous Location because Leigh Anne specified the patient came from a facility outside of Winnipeg.
- MB - I would think Leigh Anne had used the Province because the data set has no Postal Code yet
- I just checked the query check_from_out_of_town I used to derive this and it only considered Pre-admit Inpatient Institution having geog like "out-of*"! Ttenbergen 16:57, 24 January 2025 (CST)
- Will ask Dr. Roberts what this was all about to better understand what to use now. Specifically, if we use previous location, would we only care about hospitals, or also e.g. nursing stations, PCH, hospice, "unknown/other" loc_types. Ttenbergen 16:51, 24 January 2025 (CST)
- Charlson categories are provided but the CCMDB Script model only includes MI, Pulmonary, Connective, Renal
- It also contains the full score as part of Charlson_nh. Ttenbergen 19:15, 25 January 2025 (CST)
- correct, there are selected subcategories and also FULL CHARLSON SCORE for those from Nursing Home. --JMojica 09:29, 27 January 2025 (CST)
- I think "connective" became "Rheumatic disease" in ICd10, right? Ttenbergen 16:41, 24 January 2025 (CST)
- Yes it refers to Connective Tissue Disease-Rheumatic Disease. --JMojica 09:29, 27 January 2025 (CST)
- ADLmean_nh - in the CCMDB Script it is written -- Adlmean_nh = (ADLScore - 12)*(from a nursing home), what does 12 mean?
- Very good question. The function adl_sc used to get the individual scores just generates a score of 0, 3 or 6, or -1 if given bad input. That doesn't explain why -12. And I can't imagine why this would be. But it's consistent between two functions, so unlikely to be just a finger fumble. Ttenbergen 19:15, 25 January 2025 (CST)
- looks like ADLmean does not imply average of the 6 individual ADL categories (e.g. total ADL SCore/6) but (TOTAL ADL Score -12). I'm guessing here, maybe 12 is the Grand Mean of total ADL and Leigh Anne is trying to evaluate the deviation of the individual data point from the mean of the dataset of those from Nursing Home . --JMojica 09:29, 27 January 2025 (CST)
| 5 March 2025 01:56:38 |
| Re-analysis and generation of Overstay2 model | all
Julie
Tina | add a table of admission numbers by year and site
- What was the consideration for the initial choice of, I think, 0.051?
- initial thoughts were "15-17% being red, with an aim to get 60-75% of overstay patients"
Do you have numbers for something like false positives/ false negatives/ positive predictive value/ etc? Will rely on you to make this something that would satisfy someone questioning this from a statistical angle. Ttenbergen 15:19, 23 February 2025 (CST)
- Does this page miss anything that is not addressed elsewhere as per pages either linked from here or from Overstay2 Overview? If not feel free to delete this question. Ttenbergen 15:19, 23 February 2025 (CST)
Still needs:
- is this really simply "to a non-hospital location" or is it the same as above: "to a destination outside of the hospital of the admission (can be to other hospital)"?
number | 11 March 2025 22:24:07 |
| Readmission to MedWard | Julie |
| 20 March 2025 02:51:18 |
| Service/Location field | Lisa |
| 16 April 2025 19:48:25 |
| s_dispo table | Julie |
- "Hospice - other, WPG" is currently not grouped as Hospital = "Other Institution in WPG" as the other hospices - should it be? Ttenbergen 17:03, 11 March 2025 (CDT)
| 12 March 2025 05:26:14 |
| s_dispo.center | Julie | Is this just an arbitrary sorting of units or is there a plan to it? Ttenbergen 16:02, 11 March 2025 (CDT) | 11 March 2025 22:09:28 |
| s_dispo.geog | Julie | == Use ==
???
Should these be geog = winnipeg
- Interventional Radiology
- Other Procedure Location
| 12 March 2025 04:47:50 |
| s_dispo.loc_type | Julie |
in s_dispo table HSC Lennox Bell is listed as loc_type=unknown/other ; many in that location would be most similar to "home", so should these be grouped as "non-patient" instead? Wherever we deal with "home", are we already including these? For example, for Readmission to MedWard, would we include anyone who has been discharged to a "non-patient" location, or do we use more explicit groupings? Ttenbergen 15:24, 11 March 2025 (CDT)
also in s_dispo table HSC Lennox Bell is listed as site=HSC; it kind of is, but wherever that column is used to group, would this be a location we would expect in that group? Or should it be blank? Ttenbergen 15:24, 11 March 2025 (CDT)
| 11 March 2025 22:13:35 |