Pre-admit Inpatient Institution field

Data Element (edit)
Field Name:	Pre_admit_Inpatient_Institution
CCMDB Label:	Pre-admit Inpatient Institution
CCMDB tab:	Dispo
Table:	L_Log table
Data type:	number
Length:	long integer
Program:	Med and CC
Created/Raw:	Raw
Start Date:	2016-07-01
End Date:	2300-01-01
Sort Index:	36

The most recent previous inpatient location of patients who were already inpatients elsewhere and who have been under medical care continuously before coming to our unit.

• SMW

Legacy implementation right in the table

• Cargo

• Categories

• Forms

Collection Instruction

• For each patient, enter the most recent in-patient location where the patient has been admitted during this continuous episode of hospitalization at this or other hospitals
  • for places where we collect, use the Service/Location used by the counterpart laptop: <site>_Med, GH-CC, HSC MICU , HSC SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU
  • for wards where we don't collect: <site>_Ward or other external entry e.g. home

Example:

HSC MICU --- family medicine ward at the Vic --- HSC_ER --- STB_ER --- cath lab --- HSC_MICU. Code the Pre-admit Inpatient Institution field as: VIC_Ward

• if you know the situation but nothing on the list matches closely, enter other - known but not listed
• if the situation is unknown, enter location missing/unknown
• if the patient did not come from an inpatient location, enter "not applicable"

for example if they came from home or a clinic. The ER (at your site or elsewhere) is not an inpatient location, so enter "not applicable" for these

Where to find this information

If patient came from a different Winnipeg hospital this will be recorded in the “Visit History” on the EPR.

Ambiguous locations

• The following ARE NOT considered inpatient locations, enter "NA / not applicable"
  • care homes, including units with higher levels of care at any Chronic Health Facility
  • Grace Nursing Home Ward - We consider admissions from there as readmissions, so would be coded as if they had come from home. Consistent with that we will consider these not inpatient locations, so code them as "NA / not applicable". (As per meeting with Dr Roberts 2016-05-05)
  • Day-surgery locations

intra-facility and inter-facility transfers

If a patient gets transferred to another ward in the same or different hospital, enter <site>_Med, <site>_Ward or <site>_CC (as appropriate) as both the Previous Location field and the Pre-admit Inpatient Institution field.

arrivals from a borrowed bed

See and follow Previous Location field#Borrowed Bed Or Boarding Loc

several pre-admit locations

If a patient travels through several pre-admit inpatient locations we will only have data on the last one. We understand that. Just to be clear.

Example:

Pt was on a ward as an inpatient then went to ICU, then was transferred to the ward you are collecting on. Previous location would be ICU and previous inpatient institution would also be ICU.

"Can we remove the items that are no longer Service/Locations, Previous Locations, Pre-admit Inpatient Institutions or dispo locations from the dropdowns?"

We can and will remove them, but that can only happen once no more laptops use them. We will need to keep track of this and then remove them when ready. If I removed them now, then any box that currently has them enter would misbehave.

query of what is currently available

SQL

SELECT s_dispo.location_name, s_dispo.Site, s_dispo.active, s_dispo.inpatient, s_dispo.previous_location, s_dispo.s_location, s_dispo.dispo FROM s_dispo WHERE (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.inpatient)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.previous_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.s_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.dispo)=True));

Query of what is currently used

query z_s_dispo_inactivatable

Data Use / Purpose

To document where those patients who were inpatients immediately before arriving on our ward/unit came from.

The detailed information will allow us also to distinguish between patients who were or were not inpatients before arrival. This is relevant to a patient's risk of bad outcomes.

The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.

Data Integrity Checks (automatic list)

	App	Status
Query check prev pre-admit consistent	CCMDB.accdb	implemented
Function Validate Pre admit Inpatient Institution	CCMDB.accdb	implemented
Check function preAdmit NE Location	CCMDB.accdb	implemented
Check Accept Loc Park	CCMDB.accdb	retired
Link suspect mismatch pre inpt ours incomplete query	Centralized data front end.accdb	implemented
Link suspect not same visitAdmitDtTm query	Centralized data front end.accdb	implemented

Reports

• The information will be part of the Inter-facility transfer report (i.e. inpatients coming from other facility outside the region or within the region). Also the information will be useful for research projects where a patient will be tagged if already an inpatient before arrival to the unit or ward. JMojica 11:45, 2016 June 6 (CDT)

Implementation

The field is populated with options from the s_dispo table.

Legacy

This field is part of the 2016 Time and Place changes and did not previously exist.

Nursing stations

We used to collect nursing stations in hospital previous but would not include them under the new scheme because they are not inpatient locations. Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.