Pre-admit Inpatient Institution field: Difference between revisions

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''This field is currently being implemented, please check the instructions and put a discussion for anything that isn't clear. ''
{{Data_element
 
| field_name = Pre_admit_Inpatient_Institution
The [[Pre-admit Inpatient Institution field]] identifies the '''previous inpatient location''' of patients who were already '''inpatients''' elsewhere before coming to our unit '''from a [[Previous Location field | Previous location]] that is temporary'''(such as an ER). This does not include patients who just arrived at an ER elsewhere and were not admitted as inpatient there.
| CCMDB_label = Pre-admit Inpatient Institution
 
| CCMDB_tab = Dispo
For example, a patient arriving from Selkirk Hospital via the local ER would have the ER coded in the [[Previous Location field]] and Selkirk coded in the [[Pre-admit Inpatient Institution field]].
| element_description = 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.
| in_table = L_Log table
| data_type = number
| datafield_length = long integer
| program_collecting = Med and CC
| created_raw = Raw
| data_element_start_date = 2016-07-01
| data_element_sort_index = 36
}}


== Collection Instruction ==
== Collection Instruction ==
If the [[Previous Location field]] does '''not contain a "temporary" location''', leave this field blank.
* 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
 
{{PrePrevDispo listing}}
If the [[Previous Location field]] '''contains a "temporary" location''' like an ER, OR or Cath Lab you will need to enter this field. In that case, for each patient,
{{Ex |
* enter the option that most closely matches
*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 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 situation is unknown, enter '''location missing/unknown'''
 
* if the patient did not come from an '''in'''patient location, enter "not applicable"  
If you know how we code the location exactly, you can type it. Otherwise press the "magic wand" button to take you to the [[S dispo chooser‎]] to help filter options if desired.
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 ===
=== Where to find this information ===
If patient came from a different Winnipeg hospital this will be recorded in the  “Visit History” on the EPR.
If patient came from a different Winnipeg hospital this will be recorded in the  “Visit History” on the EPR.


=== Example ===
=== Ambiguous locations ===
*ICU Vic---family medicine ward at the Vic---ED HSC---ED STB---cath lab---ICU HSC. 
*The following '''ARE NOT''' considered inpatient locations, enter "NA / not applicable"
**The PrevInptLocation field is: VIC_Ward
** 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


==Questions==
=== intra-facility and inter-facility transfers  ===
=== From Ambulatory Care via ER ===
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]].
{{discussion}}
* if a pt comes from Ambulatory care direct to ward but waits in ER for ward bed to be ready, where is Ambulatory care (as location for direct admit) entered if previous location was the ER?  Pre-admit inpatient field does not include that option. we are able to choose that option from the "admit from" field under the reg & adl tab.
** Ambulatory care is not an inpatient location, so it is correct for it not to be available in [[Pre-admit Inpatient Institution field]]. Code this the way you would previously have coded the "admit from" field. Or is there a reason not to do it the same way? Ttenbergen 17:44, 2016 April 25 (CDT)


=== ER -> cath lab -> ward scenario ===
=== arrivals from a borrowed bed ===
*If the previous location is the heart cath lab (which is a temporary location), then I should add a pre-admit inpatient institution.  However, if the patient comes to the cath lab from ER, I cannot put this location because it also is a temporary location. Currently we do not put in the heart cath lab as a place to admit from, instead we use where they were located just prior to the cath lab  (ER in this example). I thought that Julie tracked Winnipeg hospital use of ER's for Randy so if we will no longer be able to put that the pt came from ER in this setting, then this will be entirely missed.  Just checking!  --[[User:LKolesar|LKolesar]] 14:21, 2016 April 14 (CDT)
See and follow [[Previous Location field#Borrowed Bed Or Boarding Loc]]


=== Direct Admission ===
=== several pre-admit locations ===
* If your patient is a direct admission from a different hospital ward (ie STB ward) is your [[Pre-admit Inpatient Institution field]] the same as [[Previous Location field]] would both be STB ward?
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.
** Yes. Ttenbergen 17:44, 2016 April 25 (CDT)


=== Grace changes requested ===
{{Ex |  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.}}
*Missing from Grace: S2, S4, S5 (unless we just put GRA_ward for all units that we currently don't collect on)
**GRA_emip is not a pre admit location
**Can we change W3 to S3 as it is no longer called W3 (unit was expanded)?[[User:Mschaffer|Mschaffer]]


=== long term patients ===
{{Location dropdown cleanup}}
{{discussion}}
*When we have patients moving from ward to ward, we normally do not go back to their original admission date to gather data especially as some patients have been admitted for over a year. Will it be acceptable to continue this practice?--[[User:CMarks|CMarks]] 12:39, 2016 April 11 (CDT)
** someone who is moving from ward to ward their previous location would be the previous ward. So, I am not sure, what do you mean? Or are you talking about the [[Pre-admit Inpatient Institution field]] or the [[Previous Service field]]?  Ttenbergen 18:21, 2016 April 11 (CDT) Ttenbergen 17:32, 2016 April 25 (CDT)


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


== {{CCMDB Data Integrity Checks}} ==
== Cross Checks ==
* Records for all [[Admit from]]s in [[#Temporary locations]] need to have an entry (possibly "none")
{{Data Integrity Check List}}
* Records for all [[Admit from]]s ''not'' in [[#Temporary locations]] need to '''not''' have an entry
Not yet implemented Ttenbergen 14:11, 2015 May 27 (CDT)
*{{discussion}} do these make sense?  (old q from Tina)
**YES.  if these are done, you may delete the ones I wrote above.  [[User:JMojica|JMojica]] 12:31, 2015 May 28 (CDT)


== Reports ==
== Reports ==
{{discussion}} Which reports will this be on? Ttenbergen 10:33, 2016 March 22 (CDT)
*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.  [[User:JMojica|JMojica]] 11:45, 2016 June 6 (CDT)


== Implementation ==
== Implementation ==
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== Legacy ==
== Legacy ==
This field is part of the [[2016 Time and Place changes]] and did not previously exist.
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. 
== Related articles ==
{{Related Articles}}


[[Category: 2016 Time and Place changes]]
[[Category: 2016 Time and Place changes]]
[[Category: Admit/Discharge]]
[[Category: Admit/Discharge]]
[[Category: Data Collection Guide]]

Latest revision as of 10:37, 2021 August 5

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
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.

Cross Checks

Data Integrity Checks (automatic list)

 AppStatus
Query check prev pre-admit consistentCCMDB.accdbimplemented
Function Validate Pre admit Inpatient InstitutionCCMDB.accdbimplemented
Check function preAdmit NE LocationCCMDB.accdbimplemented
Check Accept Loc ParkCCMDB.accdbretired
Link suspect mismatch pre inpt ours incomplete queryCentralized data front end.accdbimplemented
Link suspect not same visitAdmitDtTm queryCentralized data front end.accdbimplemented

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.

Related articles

Related articles:
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